Food Insecurity and Cardiovascular Health in Pregnant Women: Results From the Food for Families Program, Chelsea, Massachusetts, 2013-2015.
Food insecurity, uncertainty about the ability to acquire adequate food, is associated with cardiometabolic disease in pregnant women. Whether food insecurity interventions improve cardiometabolic health is unknown.



We conducted a retrospective analysis of women who visited the obstetrics clinic in a community health center from 2013 through 2015. Patients could be referred to the Food for Families (Food for Families) program, which connects food insecure women to food resources. We hypothesized that participation in Food for Families would be associated with better blood pressure and blood glucose trends during pregnancy. We used a propensity score-matched design to reduce bias from differential entry into Food for Families.



Eleven percent of women who visited the obstetrics clinic were referred to Food for Families. In propensity score-matched analyses, we found no difference in baseline systolic blood pressure (SBP) between those who were referred and enrolled in Food for Families (113.5 mm Hg), those who were referred and did not enroll in Food for Families (113.9 mm Hg), and those who were not referred to Food for Families (114 mm Hg) (P = .79). However, during pregnancy, women who were referred to and enrolled in Food for Families had a better SBP trend (0.2015 mm Hg/wk lower, P = .006). SBP trends did not differ between women who were referred and did not enroll in Food for Families and those who were not referred. We observed no differences in blood glucose trends between groups (P = .40).



Food for Families participation was associated with better blood pressure trends in pregnant women but no differences in blood glucose trends. Food insecurity reduction programs may improve cardiovascular health for vulnerable pregnant women, and this topic deserves further study incorporating randomized program entry.
Harvard Medical School, Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts.
Mary E
ME
Morales
Center for Community Health Improvement, Massachusetts General Hospital.
Michael H
MH
Epstein
Center for Community Health Improvement, Massachusetts General Hospital.
Danelle E
DE
Marable
Center for Community Health Improvement, Massachusetts General Hospital, Massachusetts General Hospital Chelsea HealthCare Center, Chelsea, Massachusetts.
Sarah A
SA
Oo
Division of General Internal Medicine and Diabetes Population Health Research Center, Massachusetts General Hospital/Harvard Medical School, 50 Staniford St, 9th Floor, Boston, MA 02114. Email: SABerkowitz@partners.org. Dr Berkowitz is also affiliated with Harvard Medical School, the Division of General Internal Medicine and the Diabetes Center, Massachusetts General Hospital, Boston, Massachusetts.
Seth A
SA
Berkowitz
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D001794:Blood Pressure; D005260:Female; D063105:Food Assistance; D005523:Food Supply / Q000706:statistics & numerical data*; D006801:Humans; D008404:Massachusetts; D011203:Poverty; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult
D001786:Blood Glucose