Abstract
To investigate the impact of household food insecurity during the third trimester of pregnancy on the growth indicators of infants aged less than 6 months. Retrospective longitudinal study. 137 healthcare centres (15 cities) in Khorasan Razavi province, Iran. Data were extracted from the Sina Electronic Health Record System (SinaEHR®). This study was conducted on 2481 mother and infant dyads during November 2016-March 2019. The Household Food Insecurity Access Scale (nine-item version) was used to measure food insecurity in the third trimester of pregnancy. Women who delivered singleton infants were included in the study, and anthropometric indices of infants were measured throughout the first 6 months of life. Approximately 67 % of the participants were food secure, while 33 % had varying degrees of food insecurity. The children born to the mothers in the food-insecure households were, respectively, 2·01, 3·03, and 3·83 times more likely to be stunted at birth (95 % CI 1·17, 3·46), 4 months (95 % CI 1·21, 7·61) and 6 months of age (95 % CI 1·37, 10·68) compared to their counterparts in the food-secure households. However, there were no significant differences in mean birth weight, birth height and head circumference at birth between the two groups. Household food insecurity during pregnancy is a risk factor for stunting in infants aged less than 6 months. Therefore, national nutrition programs could considerably support women in food-insecure households during and before pregnancy.
Highlights
This study aimed to investigate the effects of household food insecurity (HFI) during the third trimester of pregnancy on the growth indicators of infants aged less than 6 months
Our findings indicated that the mean weight-forage Z scores (WAZ) and height-for-age Z scores (HAZ) were significantly lower in infants aged 6 months born to food-insecure mothers
HFI during pregnancy may be a risk factor for stunting in infants aged less than 6 months
Summary
Study design, sampling and inclusion criteria In this retrospective longitudinal study, data were collected from Sina Electronic Health System (SinaEHR®) during November 2016–March 2019. Sociodemographic and anthropometric measurements The sociodemographic and anthropometric data, including age, education level, smoking during pregnancy, medical history of the mother and infant, place of residence and maternal pre-pregnancy BMI were collected using a questionnaire which was developed and applied via the SinaEHR. Anthropometric variables of infants (weight, height, and head circumference at birth, second, fourth and sixth months of life) and their mothers (weight and height) were measured by trained personnel using standard protocol. Infants’ weight was measured with minimal clothing using a Seca scale with an accuracy of 10 g (Seca 725, Hamburg, Germany). Multinomial logistic regression was applied considering food insecurity as a factor and the covariates of maternal age, pre-pregnancy BMI, education level and parity. In all the statistical analyses, the P-value of less than 0·05 was considered significant
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