402: Association between food deserts and pregnancy outcomes

Abstract

Food insecurity is associated with adverse health outcomes and has been associated with gestational diabetes (GDM), low birth weight, and preterm birth during pregnancy. Food Deserts (FD) are a major contributor to food insecurity. There are few studies investigating FD and pregnancy. Our objective was to determine the effect of FD on pregnancy outcomes. We performed a retrospective cohort study of singleton deliveries at a tertiary center over a one year period. The primary exposure was living in a FD. We defined FD as living one mile for urban and 10 miles for rural communities from a fresh food purveyor. This was determined using the Department of Agriculture’s Economic Research Service Food Access Research Atlas, the 2015 directory of supermarkets, and the 2010 Decennial Census data. Our primary outcomes were spontaneous preterm delivery (SPTD), pregnancy-induced hypertension (PIH), and GDM. Logistic regression was performed to account for potential confounders including race, parity, and neighborhood demographics. Adjusted odds ratios (aOR) with 95% confidence intervals were calculated. A p < 0.05 indicated statistical significance. 3,576 women gave birth during the study period. 36 women were excluded due to missing address information or whose primary address was not in the MidSouth. Women living in FD (n=1332) were more likely to be African American and multiparous. Additionally, women living in FD were more likely to live in urban neighborhoods with higher poverty rates and lower median family incomes. The incidence of SPTD was higher for women in FD (13.4% vs. 11.5%, p=0.037).The aOR was 1.273 (CI 1.014-1.597).There was no statistically significant difference in rates of PIH and GDM after adjusting for confounders. Our study indicates that women in FD are 27.3% more likely to experience SPTD even after accounting for potential confounders such as race and neighborhood poverty. Our study provides further insight into societal factors at the neighborhood level that may contribute to perinatal outcomes.