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Association between food deserts and gestational diabetes mellitus
Conference poster   Open access   Peer reviewed

Association between food deserts and gestational diabetes mellitus

Grace C. Banner, Kingsley N. Weaver, Tamara Rushovich, Sloane L. York and Lynn M. Yee
American journal of obstetrics and gynecology, v 218(1), pp S557-S558
Jan 2018
DOI: https://doi.org/10.1016/j.ajog.2017.11.428
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https://doi.org/10.1016/j.ajog.2017.11.428View
Published, Version of Record (VoR) Open Maybe Open Access (Publisher Bronze)

Abstract

Objective Food insecurity is associated with obesity and diabetes outside of pregnancy, and limited perinatal data suggest gestational diabetes mellitus (GDM) is more frequent in areas of high fast food and low supermarket density. Our objectives were to determine the relationship between food deserts in an urban setting and frequency of and obstetric outcomes related to GDM. Study Design This is a population-based, retrospective cohort study of all singleton births in the City of Chicago from 2010-2014. Women with pre-gestational diabetes or unknown GDM status were excluded. De-identified birth certificate data maintained in a centralized registry by the Chicago Department of Public Health were analyzed. Patient-level data were geo-mapped by census tract. Census tracts were categorized as ‘food deserts’ (FD) if they met the USDA Food Access Research Atlas definition that the majority of residents in these areas were low income and lived >1/2 mile from the nearest major food outlet. A sensitivity analysis was performed with a 1-mile distance used to define a food desert as well. The primary outcome was frequency of GDM. Secondary outcomes, including maternal and neonatal outcomes, were assessed among women with GDM. Bivariable, multivariable, and geo-mapping techniques (Figure) were applied. Results 8,709 (4.5%) of the 191,947 eligible women were diagnosed with GDM. Women in food deserts were more likely to be younger, obese, of minority race/ethnicity, and multiparous. The frequency of GDM was lower in FD (3.84% vs. 4.77%, p<0.001); this finding persisted when controlling for potential confounders (aOR 0.91; CI 0.86-0.96). Regarding secondary outcomes among women with GDM, those living in a FD experienced greater frequency of multiple adverse maternal and neonatal outcomes; however, these associations did not remain significant on multivariable analysis (Table). Results were similar in the sensitivity analysis. Conclusion In contrast to prior work, our findings suggest that women living in Chicago were less likely to develop GDM if they lived in a food desert. Once diagnosed with GDM, women living in food deserts did not experience poorer maternal and neonatal outcomes after controlling for potential confounders, suggesting that social or environmental factors other than food access may contribute to perinatal outcomes.

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Collaboration types
Domestic collaboration
Web of Science research areas
Obstetrics & Gynecology
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