Abstract
Objective This study aimed to estimate the association of household food insecurity with gestational
diabetes mellitus (GDM) risk by race and ethnic group.
Study Design The study was a secondary analysis from the National Health and Nutrition Examination
Survey from 2007 to 2018. A survey-weighted logistic regression model was constructed
with self-reported GDM as the response. The primary independent variable was a four-level
food security indicator, defined as the inability to obtain food in a socially acceptable
way due to the lack of financial resources and controlled for several established
risk factors. Analyses were stratified by race (White and Black) and ethnicity (Hispanic)
to provide insight into how gestational diabetes risk differs by subpopulation.
Results Results indicated that family history of diabetes is a risk factor across all races
(adjusted odds ratio [aOR]: 4.22–16.26), while household food insecurity is a significant
risk factor for only Hispanic women living with a partner (aOR: 8.50 for very low
food security).
Conclusion In the United States, Hispanic women's GDM risk may be uniquely impacted by food
insecurity.
Key Points
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This study provides a national estimate of the GDM risk from food insecurity by race
and ethnicity.
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The results in this study suggest a statistically significant relationship between
household food insecurity and an increasing risk of developing GDM for Hispanic individuals.
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White women who live alone (without spouse or partner) were also at elevated risk
of GDM.
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Age at delivery, poverty ratio, and family history of diabetes are also risk factors
for the disease.
Keywords
gestational diabetes mellitus - GDM - household food insecurity - logistic regression
- NHANES
