Prevalence and risk factors of food insecurity during pregnancy: a multicenter survey in French Guiana

Background : The post-COVID international situation, wars and food price inflation are hampering access to food for the most vulnerable households who have no safety net against unforeseen events. While pregnant women are particularly vulnerable to food shortages and nutritional imbalances, data on food insecurity during pregnancy and associated risk factors are scarce. Methods : A 2023 multi-center, cross-sectional study was conducted among a representative sample of 730 women during the third trimester of pregnancy in French Guiana. Food insecurity (USDA Food Security Survey Module), diet quality indicators derived from a qualitative 24-hour recall (Minimum Dietary Diversity for Women MDD-W, All-5 indicator, NCD risk foods), pre-conceptional nutritional status (body mass index – BMI) and gestational weight gain (GWG), and women’s self-esteem were collected. Data were weighted to ensure sample representativeness, and modified Poisson regression was used to identify risk factors for FI during pregnancy. Results : Overall, 32.3% [95% CI: 28.8-35.9] of the women lived in a food-insecure household during pregnancy and only 45.6% [95% CI: 42.0-49.2] of the women had reached the MDD-W set at 5 food groups. More than 80% of the women had consumed sweetened beverages and 25.1% were obese before conception. According to the multivariate model, the factors positively associated with food insecurity included living in substandard housing, living alone with children, having low self-esteem and being born abroad (with or without a residence permit). On the other hand, having a stable and declared income and social support were protective factors against food insecurity after adjusting for the other variables. Conclusions : This study highlights a frequently overlooked situation in French Guiana that is likely to affect the health of children at the very beginning of their lives. Peer-based programs or government financial assistance programs could help strengthen the ability of the poorest households with pregnant women to cope with food insecurity