Association of maternal food insecurity before and during pregnancy with fetal structural anomalies: A multicenter case-control study protocol

Abstract

Background:

Food insecurity, an issue also affecting developed countries, is associated with different negative outcomes. Particularly in pregnant women, a vulnerable population group, it has a double burden, as it affects both the woman and her child. Food insecurity has been associated with low birth weight and shorter gestational age, but there is less evidence on the association with fetal structural anomalies.

Aim:

To fill this gap, a study will be conducted to examine if pregnant women in a condition of food insecurity have a higher risk for fetal structural anomalies.

Methods:

A case-control study will be conducted in three centers. Cases will be pregnant women (>18 years old) diagnosed with a fetal structural anomaly during the prenatal ultrasound examination of the II–III trimester, while controls will be pregnant women (>18 years old) with a negative result for fetal structural anomaly at the II–III trimester prenatal ultrasound examination. The exposure of interest will be food insecurity during the last 12 months, measured using the validated Household Food Insecurity Access Scale. A dedicated questionnaire will be given to women after they sign the informed consent form.

Summary:

Finding a positive association between food insecurity in pregnant women and fetal structural anomalies could be the first step towards screening for it among pregnant women and designing policies that could mitigate this condition. Lowering food insecurity could prevent a certain number of fetal structural anomalies, leading to fewer negative pregnancy outcomes and health problems during childhood and adulthood.

Keywords

Pregnancy food insecurity food security fetal structural anomalies prevention

Get full access to this article

View all access options for this article.

References

Carmichael

Yang

Herring

, et al. (2007) Maternal food insecurity is associated with increased risk of certain birth defects. Journal of Nutrition 137(9): 2087–2092.

Coates

Swindale

Bilinsky

(2007) Household Food Insecurity Access Scale (HFIAS) for Measurement of Household Food Access: Indicator Guide (v. 3). Washington, D.C.: Food and Nutrition Technical Assistance Project, Academy for Educational Development. Available from: http://www.fao.org/fileadmin/user_upload/eufao-fsi4dm/doc-training/hfias.pdf (accessed 12 December 2019).

Coleman-Jensen

Rabbit

Gregory

, et al. (2017) Household Food Security in the United States in 2017, ERR-256, U.S Department of Agriculture Economic Research Service. Available at: https://www.ers.usda.gov/publications/pub-details/?pubid=90022 (accessed 11 December 2019).

EU Data Protection Directive (1995) Directive 95/46/EC of the European Parliament and of the council of 24 October 1995 on the protection of individuals with regard to the processing of personal data and on the free movement of such data. Official Journal of the European Communities 38(281): 31–50. Available at: http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:31995L0046 (accessed 12 December 2019).

FAO, IFAD, UNICEF, WFP and WHO (2019) The State of Food Security and Nutrition in the World 2019. Safeguarding against economic slowdowns and downturns. Rome: FAO. Available at: http://www.fao.org/3/ca5162en/ca5162en.pdf (accessed 12 December 2019).

General Data Protection Regulation (2016) Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC. Official Journal of the European Union 59: 1–88. http://eur-lex.europa.eu/pri/en/oj/dat/2003/l_285/l_28520031101en00330037.pdf. (accessed 12 December 2019).

Grilo

Earnshaw

Lewis

, et al. (2015) Food matters: Food insecurity among pregnant adolescents and infant birth outcomes. Journal of Applied Research on Children 6(2): 4. Available at: http://digitalcommons.library.tmc.edu/childrenatrisk/vol6/iss2/4 (accessed 12 December 2019).

Harris

Taylor

Thielke

, et al. (2009) Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Information 42(2): 377–381.

Hassan

(2012) Recall bias can be a threat to retrospective and prospective research designs. The Internet Journal of Epidemiology 3(2).

10.

Hobel

Goldstein

Barrett

(2008) Psychosocial stress and pregnancy outcome. Clinical Obstetrics and Gynecology 51(2): 333–348.

11.

Hoseini

Kazemi

Alimoradi

, et al. (2018) Association between household food security and pregnancy complications. Social Health and Behavior 1(2): 26–30.

12.

Howards

Johnson

Honein

, et al. (2015) Adjusting for bias due to incomplete case ascertainment in case-control studies of birth defects. American Journal of Epidemiology 181(8): 595–607.

13.

Laraia

Siega-Riz

Gundersen

, et al. (2006) Psychosocial factors and socioeconomic indicators are associated with household food insecurity among pregnant women. Journal of Nutrition 136(1): 177–182.

14.

Laraia

Leung

Atkins

VMA

(2013) Health and Developmental Correlates of Child Food Insecurity from Pregnancy to Early Childhood. Workshop on Research Gaps and Opportunities on the Causes and Consequences of Child Hunger. Available from: https://sites.nationalacademies.org/cs/groups/dbassesite/documents/webpage/dbasse_084309.pdf (accessed 11 December 2019).

15.

McKinney

Pisek

Chowchuen

, et al. (2016) Case-control study of nutritional and environmental factors and the risk of oral clefts in Thailand. Birth Defects Research (Part A) 106: 624–632.

16.

Sergeant

ESG.

(2018) Epitools Epidemiological Calculators. Ausvet. Available at: http://epitools.ausvet.com.au. (accessed May 2019).

17.

Verrotti

Caforio

Gramellini

, et al. (2007) Ultrasound screening in second and third trimester of pregnancy: An update. Acta Biomedica de l’Ateneo Parmense 78(3): 229–232.

18.

World Health Organization (WHO) (2010). Birth defects. Available at: http://apps.who.int/gb/ebwha/pdf_files/wha63/a63_10-en.pdf (accessed 12 December 2019).

19.

World Health Organization (WHO) (2018) WHO | International Classification of Diseases. Available at: http://www.who.int/classifications/icd/en/ (accessed 12 December 2019).

20.

Zaçe

Di Pietro

Caprini

, et al. (2020) Prevalence and correlates of food insecurity among children in high-income European countries. A systematic review. Ann Ist Super Sanità 56(1): 90–98.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.06 MB