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Cross‐sectional but not Longitudinal Measures of Food Insecurity are Associated with the Rate of Weight Gain during Pregnancy in Northern Uganda
Author(s) -
Natamba Barnabas K,
Mehta Saurabh,
Vermeylen Francoise,
Widen Elizabeth M,
Ghosh Shibani,
Griffiths Jeffrey K,
Bran Patsy M,
Young Sera L
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.899.10
Subject(s) - pregnancy , medicine , weight gain , cross sectional study , longitudinal study , gestation , obstetrics , gestational age , demography , body weight , genetics , pathology , sociology , biology
Food insecurity (FI) during pregnancy may lead to adverse health outcomes for affected women. However, little is known on whether such effects are due to short‐term within person changes (longitudinal effects) in FI or long‐term between person differences (cross‐sectional effects) in this exposure. Therefore, the aim of this study was to assess whether differences in cross‐sectional measures of FI between women (defined as the mean prenatal IFIAS score) and/or longitudinal changes in FI within women (i.e. the observed IFIAS score at each visit minus the mean (cross‐sectional) IFIAS score) were associated with the rate of weight gain during pregnancy. We enrolled 403 (33.3% HIV‐infected, all on antiretroviral treatment) pregnant women at the antenatal clinic of Gulu Hospital in northern Uganda. FI was assessed at recruitment and then at each follow‐up visit using the Individually‐focused FI Access Scale (IFIAS; Natamba et al 2014). Women's height and weight was measured at enrollment (mean (±SD) gestational age =19.4 (±−3.8) weeks) and weight was measured at each follow‐up visit. We employed linear mixed effects models to estimate the effect of a unit change in the cross‐sectional between women or longitudinal within women measures of FI on the weekly rate of gestational weight gain. Across all prenatal visits, the mean FI (IFIAS) score for HIV uninfected women (6.8 (±4.2)) was lower compared to that of the HIV‐infected group (9.1 (±4.9)), p<0.001. The rate of weight gain during pregnancy was higher in the HIV‐uninfected group (308±333.6 g/wk) than among HIV‐infected women (247±399 g/wk) (p=0.003). Adjusting for gestational age and HIV status, a one unit increase in cross‐sectional IFIAS scores between women was associated with a 6.1 g/wk lower rate of gestational weight gain (p=0.009) ( Figure 1). In unadjusted and adjusted models, there was no association between longitudinal changes (within women) in IFIAS scores and the rate of weight gain during pregnancy. These results suggest that chronic food insecurity during pregnancy adversely affected weight gain among pregnant women in Uganda. Support or Funding Information This research was funded in part by Cornell University‐Weill Medical College Inter‐campus Seed Funds, K01 MH098902 from NIMH and USAID Cooperative Agreement AID‐OAA‐L‐10‐00006 1The association between the rate of gestational weight gain and cross‐sectional differences in food insecurity between pregnant women in Uganda