title: Household food insecurity is associated with self-reported pregravid weight status, gestational weight gain, and pregnancy complications.
abstract: BACKGROUND
  Household food insecurity is positively associated with weight among women. The association between household food insecurity and pregnancy-related weight gain and complications is not well understood.
  
  
  OBJECTIVE
  To identify whether an independent association exists between household food insecurity and pregnancy-related complications.
  
  
  METHODS
  Data from the Pregnancy, Infection, and Nutrition prospective cohort study were used to assess household food insecurity retrospectively using the US Department of Agriculture 18-item Core Food Security Module among 810 pregnant women with incomes < or =400% of the income/poverty ratio, recruited between January 2001 and June 2005 and followed through pregnancy.
  
  
  METHODS
  Self-reported pregravid body mass index, gestational weight gain, second trimester anemia, pregnancy-induced hypertension, and gestational diabetes mellitus.
  
  
  METHODS
  Multivariate linear, multinomial logistic, and logistic regression analyses.
  
  
  RESULTS
  Among 810 pregnant women, 76% were from fully food secure, 14% were from marginally food secure, and 10% were from food insecure households. In adjusted models, living in a food insecure household was significantly associated with severe pregravid obesity (adjusted odds ratio 2.97, 95% confidence intervals [CIs] 1.44 to 6.14), higher gestational weight gain (adjusted beta coefficient 1.87, 95% CI 0.13 to 3.62), and with a higher adequacy of weight gain ratio (adjusted beta .27, 95% CI 0.07 to 0.50). Marginal food security was significantly associated with gestational diabetes mellitus (adjusted odds ratio 2.76, 95% CI 1.00 to 7.66).
  
  
  CONCLUSIONS
  This study highlights the possibility that living in a food insecure household during pregnancy may increase risk of greater weight gain and pregnancy complications.
authors.affiliation: Department of Medicine, Center for Health and Community, University of California, San Francisco, CA 94118, USA. laraiab@chc.ucsf.edu
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Laraia
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Siega-Riz
authors.forename: Craig
authors.initials: C
authors.lastname: Gundersen
mesh_terms: D000328:Adult; D000740:Anemia / Q000453:epidemiology / Q000209:etiology; D015992:Body Mass Index; D015331:Cohort Studies; D016001:Confidence Intervals; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology / Q000209:etiology; D016015:Logistic Models; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000453:epidemiology*; D016017:Odds Ratio; D011203:Poverty; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012650:Self Disclosure; D012959:Socioeconomic Factors; D015430:Weight Gain