Association of Food Insecurity and Short-Term Kidney Outcomes in Neonates

Abstract

Objective

This study aimed to determine the association between food insecurity (FI) and short-term kidney outcomes in neonates.

Study Design

Single-site prospective cohort study of sequentially admitted neonates to two neonatal intensive care units (NICUs). We collected demographic characteristics and FI status on maternal–neonatal dyads using the Hunger Vital Signs tool. Kidney outcomes (acute kidney injury [AKI]) within the first 14 days, recovery from AKI, and serum creatinine (SCr) at day 14 of age) were compared by FI status.

Results

Of the 70 neonates in this study, 39% lived in FI households. Infants from FI households were more likely to have early AKI (56 vs. 14%, p = 0.002) and were more likely to have a slower recovery from AKI (66 vs. 17%, p = 0.035) than those from food-secure households. Neonates from FI households were also more likely to have an abnormally elevated SCr at 2 weeks of age (66 vs. 17%, p = 0.007).

Conclusion

FI is common in families with neonates admitted to the NICU. Neonates born into FI households were more likely to have early AKI, slower AKI recovery, and elevated SCr at 2 weeks of age. Our findings emphasize the importance of FI screening and recognition as part of prenatal care and as an essential social determinant of health in studies investigating kidney outcomes.

Key Points

• FI is common in families with neonates admitted to the NICU.

• Neonates born into households with FI were more likely to have early AKI.

• They also had slower AKI recovery and elevated SCr at 2 weeks of age.

• Our findings emphasize the importance of FI screening and recognition as part of prenatal care.

• FI is an essential social determinant of health in studies investigating kidney outcomes.

Keywords

neonatal kidney disease - kidney injury - maternal malnutrition - food insecure

Authors' Contributions

M.S. conceptualized the study and assisted with study design, assisted with data analysis, provided oversight, wrote the first draft of the manuscript, and reviewed and revised the manuscript. A.H. and M.S. performed data collection assisted with the analysis and reviewed and revised the manuscript. P.C., C.S., S.P.G., and D.S. assisted with the study design and reviewed and revised the manuscript. All authors approve the final manuscript as submitted and agree to be accountable for all aspects of the work.

Ethical Approval and Patient Consent

The study was reviewed by the Institutional Review Board at Indiana University and written informed consent was obtained from enrolled families (IRB approval no.: 13604).

Publication History

Received: 13 December 2024

Accepted: 04 June 2025

Article published online:
24 June 2025

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