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Examining Maternal Experiences of Food Insecurity on Birth and Early Childhood Outcomes

dc.contributor.advisorThoma, Marie Een_US
dc.contributor.authorDe Silva, Dane Andréen_US
dc.date.accessioned2020-10-10T05:31:00Z
dc.date.available2020-10-10T05:31:00Z
dc.date.issued2020en_US
dc.identifierhttps://doi.org/10.13016/vrst-hlev
dc.identifier.urihttp://hdl.handle.net/1903/26573
dc.description.abstractFood insecurity, or the inadequate access to nutritionally-acceptable food, has been increasingly recognized as a distal determinant of poor health outcomes. While 11.1% of U.S. households suffer from food insecurity, specific populations are disproportionately affected, including pregnant women and single mothers. From a life course perspective, growth trajectories may be influenced by both prenatal exposures and postpartum practices, such as breastfeeding. Since food insecurity is associated with stress and poor nutrition, when occurring during critical periods of development, the fetus may be programmed to have poor future health. Other research on developmental origins have identified patterns that exhibit sex differences, particularly around growth. Therefore, this investigation sought to examine maternal food insecurity on: (i) low birthweight and sex-specific differences; (ii) breastfeeding initiation and exclusive breastfeeding duration; and (iii) obesity at age two and sex-specific differences. In Aim 1, mothers experiencing prenatal food insecurity had a higher odds of delivering a low birthweight infant, though much of the association was explained by sociodemographic factors after adjustment (OR 1.10 [95%CI 0.98, 1.25]), with female infants showing OR 1.21 (95%CI 1.02, 1.43). For Aim 2, food insecurity did not appear to deter women from initiating breastfeeding (OR 1.41 [95%CI 0.58, 3.47]), and minimal differences in exclusive breastfeeding duration between food insecure and food secure women were found (TR 0.89 [95%CI 0.57, 1.39]). Finally, Aim 3 revealed that sociodemographic factors explained much of the association between maternal food insecurity and childhood obesity at 2 years (OR 1.15 [95%CI 0.75, 1.75]), though male offspring showed a stronger magnitude (OR 1.54 [95%CI 0.86, 2.74]). Maternal food insecurity is a multi-faceted exposure that is related to other covariates, which may interact in multiple ways to influence health outcomes through both biologic and behavioral pathways. This preliminary investigation highlights the importance of exploring exposures occurring during critical periods, including food insecurity, on birth and childhood outcomes, and how it may affect the later health of offspring differently by sex. Additional longitudinal data with accurate measures of food insecurity are needed to fully ascertain how it affects the health of mothers and children, and to identify possible mediating pathways.en_US
dc.language.isoenen_US
dc.titleExamining Maternal Experiences of Food Insecurity on Birth and Early Childhood Outcomesen_US
dc.typeDissertationen_US
dc.contributor.publisherDigital Repository at the University of Marylanden_US
dc.contributor.publisherUniversity of Maryland (College Park, Md.)en_US
dc.contributor.departmentFamily Studiesen_US
dc.subject.pqcontrolledPublic healthen_US
dc.subject.pqcontrolledEpidemiologyen_US
dc.subject.pquncontrolledBreastfeedingen_US
dc.subject.pquncontrolledEarly childhood obesityen_US
dc.subject.pquncontrolledFood insecurityen_US
dc.subject.pquncontrolledLife Courseen_US
dc.subject.pquncontrolledLow birthweighten_US
dc.subject.pquncontrolledMaternal and Child Healthen_US


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