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Association Between Food Environments and Fetal Growth in Pregnant Brazilian Women
19 Pages Posted: 29 Jul 2022
More...Abstract
Introduction: Birth weight is described as one of the main determinants of newborns’ chances of survival. Among the associated causes, or risk factors, the mother’s nutritional status has a strong influence on fetal growth and 'birth weight' outcomes of the concept. This study evaluates the association between food deserts in small for gestational age (SGA), large for gestational age (LGA) and low birth weight (LBW) newborns.
Design: This is a cross-sectional population study, resulting from individual data from the Live Birth Information System (SINASC), and municipal data from mapping food deserts (CAISAN) in Brazil. The newborn’s size was defined as follows: appropriate for gestational age (between 10th and 90th percentile), SGA (<10th percentile), LGA (>90th percentile), and low birth weight <2,500g. To characterize food environments, we used tertiles of the density of establishments which sell in natura and ultra-processed foods. Logistic regression modeling was conducted, in order to investigate the associations of interest.
Results: We analyzed 2,632,314 live births in Brazil in 2016. Following due adjustment, it was observed that women from municipalities in which there was a limited supply of in natura foods presented a higher chance of a SGA [OR2nd tertile:1.06 (1.05-1.07)] and LBW [OR2nd tertile: 1.11(1.09-1.12)] newborn. On the other hand, municipalities in which there was a greater supply of ultra-processed foods presented higher chances for a SGA [OR3rd tertile:1.04 (1.02-1.06)] and LBW [OR2nd tertile:1.13 (1.11-1.16)] newborn. Stratification showed that black and mixed-race women were associated with SGA [OR3rd tertile: 1.09 (1.01-1.18)] and [OR3rd tertile:1.06 (1.04-1.09)], respectively, and mixed-race women were also associated with LBW [OR3rd tertile:1.17 (1.14-1.20)], while indigenous women were associated with LGA [OR3rd tertile: 1.20(1.01-1.45)].
Conclusions: Living in areas with limited access to healthy foods was associated with an increased chance of SGA and low weight newborns, especially in black and mixed-race women. Initiatives focused on minimizing the effects of these food environments, and which aim to reduce social inequalities are urgently required in the Brazilian context.
Funding Information: This study was supported by CIDACS received financial support by 330 MCTI / CNPq / MS / SCTIE / Decit / Bill & Melinda Gates Foundation’s Grandes 331 Desafios Brasil – Desenvolvimento Saudável para Todas as Crianças (call number 332 47/2014) (grant number OPP1142172).
Declaration of Interests: The authors declare no conflicts of interest.
Ethics Approval Statement: Secondary, individual, anonymized, and aggregated public domain data at the municipal level was used exclusively. Therefore, free and informed consent, and approval by the Ethics and Research Committee were exempted, in accordance with the National Health Council in Brazil, National Commission for Research Ethics Resolution Nº 466/2012.
Keywords: low birth weight (LBW), small for gestational age (SGA), large for gestational age (LGA), food deserts, and maternal-infant health
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