Maternal education modifies the association between food insecurity and risk of short IPI among low income women in Massachusetts (268.5)

Abstract

Periconceptional nutrition’s importance has been established through a large body of research, showing adverse effects of poor periconceptional nutritional status on a variety of health outcomes. This study examined the association between food security status during the Inter‐pregnancy interval (IPI) and risk of short IPI among low income women participating in MA WIC (2001‐2009). Women who were on WIC for both 1st and 2nd pregnancies, had singleton full‐term (38‐42 wks) live births, and had complete data on ethnicity, education, age, household (HH) size, pre‐pregnancy weight before 2nd pregnancy, 1st infant’s breastfeeding duration and HH food security status from the 2nd pregnancy were included in these analyses (n=10,625 mothers). IPI= the estimated date of conception for the 2nd pregnancy ‐ the birth date of the first child. Logistic regression was used to examine the association between food security and short IPI (< 12 months), controlling for the aforementioned covariates. Sample characteristics were: mean age of 22.6 years (SD=5.1 yrs), 54.6% non‐white, 23.4% with food insecurity (18.5% low food security (LFS) and 4.9% very low food security (VLFS)), and 28.5% with short IPI. HH food insecurity was associated with a higher risk of short IPI; this varied by maternal education. Among mothers with < 12 years of education, those with VLFS were 56% more likely [OR=1.56, 95%CI=1.1‐2.1] to have short IPI compared to food secure mothers. Those with LFS tended toward increased risk for short IPI [OR=1.20, 95%CI=1.0‐1.4]. Among mothers with > 12 years of education, those with LFS were 28% more likely [OR=1.28, 95%CI=1.0‐1.63] to have short IPI than food secure mothers; there was no association with VLFS risk [OR=1.39, 95%CI=0.9‐2.2]. Among mothers with 12 years of education neither LFS [OR=1.0, 95% CI=0.9‐1.2] nor VLFS [OR=0.8, 95%CI=0.6‐1.1] were associated with short IPI. Food insecurity increased the risk of short IPI in this low income population but the effect varied by maternal education.Grant Funding Source: Supported by UCLA/USDA