Hou HL, Sun GX. Associations between food insecurity with gestational diabetes mellitus and maternal outcomes mediated by dietary diversity: A cross-sectional study. World J Diabetes 2025; 16(2): 95463 [PMID: 39959276 DOI: 10.4239/wjd.v16.i2.95463]
Corresponding Author of This Article
Hong-Li Hou, BM BCh, Academic Research, Department of Gynecology and Obstetrics, Children’s Hospital of Shanxi, Women Health Center of Shanxi, No. 13 Xinmin North Street, Taiyuan 030001, Shanxi Province, China. honglihou0728@163.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 15, 2025 (publication date) through Mar 19, 2026
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Diabetes
ISSN
1948-9358
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Hou HL, Sun GX. Associations between food insecurity with gestational diabetes mellitus and maternal outcomes mediated by dietary diversity: A cross-sectional study. World J Diabetes 2025; 16(2): 95463 [PMID: 39959276 DOI: 10.4239/wjd.v16.i2.95463]
World J Diabetes. Feb 15, 2025; 16(2): 95463 Published online Feb 15, 2025. doi: 10.4239/wjd.v16.i2.95463
Associations between food insecurity with gestational diabetes mellitus and maternal outcomes mediated by dietary diversity: A cross-sectional study
Hong-Li Hou, Gui-Xia Sun
Hong-Li Hou, Gui-Xia Sun, Department of Gynecology and Obstetrics, Children’s Hospital of Shanxi, Women Health Center of Shanxi, Taiyuan 030001, Shanxi Province, China
Author contributions: Hou HL contributed to conceptualization, methodology, investigation and supervision, software, and validation; Sun GX contributed to data curation, writing- original draft preparation; All contributed to writing- reviewing and editing.
Institutional review board statement: The research received approval from Children’s Hospital of Shanxi Committee (Approval Number: KLT6230511).
Informed consent statement: Following approval from the Hospital Administrator, the Head of the Chronic Care Clinic, and the Head of the Department of Gynecology and Obstetrics, a comprehensive explanation of the study's objectives, procedures, benefits, potential risks, and participants' right to voluntary participation was provided. Written informed consent was obtained from each participant. To safeguard the confidentiality of the data, codes were assigned in place of participants' names, and unauthorized access to the collected data was strictly prohibited.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: All data generated and analyzed during this study are included in the manuscript. The datasets analyzed during the current study are available from the corresponding author upon reasonable request at honglihou0728@163.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Corresponding author: Hong-Li Hou, BM BCh, Academic Research, Department of Gynecology and Obstetrics, Children’s Hospital of Shanxi, Women Health Center of Shanxi, No. 13 Xinmin North Street, Taiyuan 030001, Shanxi Province, China. honglihou0728@163.com
Received: April 10, 2024 Revised: September 10, 2024 Accepted: October 22, 2024 Published online: February 15, 2025 Processing time: 263 Days and 15.9 Hours
Abstract
BACKGROUND
Food insecurity (FI) during pregnancy negatively impacts maternal health and raises the risk of gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH), resulting in adverse outcomes for both mother and baby.
AIM
To investigate the relationships between FI and pregnancy outcomes, particularly GDM and PIH, while also examining the mediating role of the dietary diversity score (DDS).
METHODS
A cross-sectional study was undertaken to examine this relationship, involving 600 pregnant women. Participants were women aged 18 years or older who provided complete data on FI and pregnancy outcomes. The FI was measured via the Household Food Security Survey Module, with GDM defined as fasting plasma glucose levels of ≥ 5.1 mmol/L or a 2-hour oral glucose tolerance test value of ≥ 8.5 mmol/L. The DDS is determined by evaluating one's food consumption based on nine distinct food groups. A logistic regression model was used to explore the relationship between FI and PIH, and GDM.
RESULTS
Seventeen percent of participants reported experiencing FI during pregnancy. The study found a significant association between FI and an elevated risk of GDM [odds ratio (OR) = 3.32, 95%CI: 1.2-5.4]. Once more, food-insecure pregnant women had higher rates of PIH (OR = 0.10, 95%CI: 0.02-0.45) and they also faced a higher likelihood of neonatal complications, such as neonatal intensive care unit’s admissions and the birth of infants with extremely low birth weight. The FI was further linked to metabolic disruptions, such as elevated fasting blood sugar (FBS), low-density lipoprotein cholesterol, and triglyceride levels. Our results indicate that the DDS acts as a significant mediator in the relationship between FI and the incidence of GDM. In particular, the mediation analysis showed that approximately 65% of the effect was mediated through DDS (P = 0.002).
CONCLUSION
These findings underscore the serious challenges that FI presents during pregnancy and its effects on maternal and infant health. Additionally, the study explored how DDS mediates the relationship between FI and the incidence of GDM.
Core Tip: Ensuring proper nutrition and food security during pregnancy is vital for maintaining maternal health and reducing the risk of complications like gestational diabetes mellitus and pregnancy-induced hypertension. Promoting dietary diversity and addressing food insecurity can lead to healthier outcomes for both mother and baby. Healthcare providers and policymakers should prioritize addressing these issues to improve overall maternal and infant health.
