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Birth outcomes in relation to neighborhood food access and individual food insecurity during pregnancy in the Environmental Influences on Child Health Outcomes (ECHO)-wide cohort study
Journal article   Open access   Peer reviewed

Birth outcomes in relation to neighborhood food access and individual food insecurity during pregnancy in the Environmental Influences on Child Health Outcomes (ECHO)-wide cohort study

Izzuddin M Aris, Pi-I D Lin, Allison J Wu, Dana Dabelea, Barry M Lester, Rosalind J Wright, Margaret R Karagas, Jean M Kerver, Anne L Dunlop, Christine LM Joseph, …
The American journal of clinical nutrition, v 119(5), pp 1216-1226
May 2024
PMID: 38431121
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11130689View
Published, Version of Record (VoR) Open Open Access (License Unspecified)

Abstract

birth weight food insecurity gestational age health disparities neighborhood food access Epidemiology
Limited access to healthy foods, resulting from residence in neighborhoods with low-food access or from household food insecurity, is a public health concern. Contributions of these measures during pregnancy to birth outcomes remain understudied. We examined associations between neighborhood food access and individual food insecurity during pregnancy with birth outcomes. We used data from 53 cohorts participating in the nationwide Environmental Influences on Child Health Outcomes-Wide Cohort Study. Participant inclusion required a geocoded residential address or response to a food insecurity question during pregnancy and information on birth outcomes. Exposures include low-income-low-food-access (LILA, where the nearest supermarket is >0.5 miles for urban or >10 miles for rural areas) or low-income-low-vehicle-access (LILV, where few households have a vehicle and >0.5 miles from the nearest supermarket) neighborhoods and individual food insecurity. Mixed-effects models estimated associations with birth outcomes, adjusting for socioeconomic and pregnancy characteristics. Among 22,206 pregnant participants (mean age 30.4 y) with neighborhood food access data, 24.1% resided in LILA neighborhoods and 13.6% in LILV neighborhoods. Of 1630 pregnant participants with individual-level food insecurity data (mean age 29.7 y), 8.0% experienced food insecurity. Residence in LILA (compared with non-LILA) neighborhoods was associated with lower birth weight [β –44.3 g; 95% confidence interval (CI): –62.9, –25.6], lower birth weight-for-gestational-age z-score (–0.09 SD units; –0.12, –0.05), higher odds of small-for-gestational-age [odds ratio (OR) 1.15; 95% CI: 1.00, 1.33], and lower odds of large-for-gestational-age (0.85; 95% CI: 0.77, 0.94). Similar findings were observed for residence in LILV neighborhoods. No associations of individual food insecurity with birth outcomes were observed. Residence in LILA or LILV neighborhoods during pregnancy is associated with adverse birth outcomes. These findings highlight the need for future studies examining whether investing in neighborhood resources to improve food access during pregnancy would promote equitable birth outcomes.

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being
#1 No Poverty
#2 Zero Hunger

Source: SDGs in the Output

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Collaboration types
Domestic collaboration
Web of Science research areas
Nutrition & Dietetics
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