Journal of Midwifery & Women s Health, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 26, 2024

Nutrition during pregnancy remains a significant public health concern globally, including within the United States. Adequate food sources play crucial role at every gestational stage of pregnancy, impacting perinatal well-being, fetal development, and long-term maternal child health. Current evidence has shown that nutrition in utero can result epigenetic changes offspring have lasting effects on eventual adult health.1-3 It is estimated only 38.2% US women had normal prepregnancy weight, more than half met diagnostic criteria for obesity prior to (body mass index >30).4, 5 However, concerns extend beyond include underweight status, which also poses risks growth.6 Regardless advancements addressing underweight, regional disparities persist, accompanied by minimal no progress other indicators such as anemia.6 With implementation insecurity assessments, would access resources improved outcomes.7 One Healthy People 2030 goals reduce rate household because this issue continued worsen.8 Addressing use high-cost care services.9 In study done Feeding America, over 40 million Americans States experienced insecurity, costing an additional $53 billion dollars annually economy.10, 11 Study participants facing greater usage, leading higher annual expenditures compared with those adequate security.10, Moreover, assessment into prenatal services provide pregnant individuals food. This then allow them maintain better overall themselves their growing fetus need emergency room visits, inpatient hospitalization, outpatient urgent care.10 Continuing education (CE) available article. To obtain CE online, please visit http://www.jmwhce.org. A form includes test questions print edition issue. Food affects number people global population, nearly one-third lacking food.12 Although much attention been directed toward hunger among low- middle-income countries, there recognition presence hidden high-income countries. States, 13.8 households, constituting 10.5% are affected insecurity.13 Prior COVID-19 pandemic, 10% households rates observed rural children. 2019, 12.1% 10.3% urban areas.14 based statistics from Department Agriculture (USDA), increased 13.5% 2023, showing statistically increase insecure after pandemic.15 carries implications both newborn Research links stress, weight gain, development diabetes.16, 17 it associated adverse outcomes preterm birth, low birth hospitalizations infants under 6 months age,18 well inadequate infant feeding practices.19 Additionally, compromise dietary quality exacerbating outcomes. Given enduring consequences growth development.20 During lactation, when nutritional demands increase, numerous micronutrient deficiencies, vitamins A,D, B6, B12, choline, zinc, remain prevalent.21 Factors climate change, economical conflicts anticipated exacerbate challenges related availability accessibility nutritious worldwide year 2030.12 past research trends Black, Hispanic, multiracial be double non-Hispanic White households.22 These were likely less services, resulting lower depressive symptoms, risk mortality.7 The USDA defines security circumstances reports reduced quality, variety, or desirability (with little indication intake).23 Very occurs multiple disrupted eating patterns intake.23 definitions not dichotomous occur along continuum between insecurity. Other exist focused importance limited restricted food.24 definition supported findings conducted using data National Health Examination Survey (NHANES), demonstrated did correlate diet quality.25 Therefore, may food, but high nutrient addition screening social determinants health, American College Obstetricians Gynecologists,26 Academy Pediatrics,27 Physicians28 recently endorsed universal all approach destigmatizes normalizes routine part assessments.26 For marginalized populations particular, many disparities, especially Black individuals.7, 29, 30 identifying persons setting up referral systems community partnerships intervene early intervention.18 tool validated Hunger Vital Sign.31 2-item questionnaire was created specifically children later adults settings (Table 1).31 version developed standard 18-item Household Security researchers analyzed 30,098 families who screened.31 screen sensitivity (97%) specificity (83%), validating its usage reliable clinical security. ensures positive receive appropriate services.31 Never true Sometimes truea Often Patient declined Screening any individual, patient, family, one step. process twofold, requiring operating procedure ensure facilitation positive. required team-based delivery patient-centered care. Some internal mechanisms assist identified patients, whereas others require external coordination.32 Enrolling eligible programs Special Supplemental Program Women, Infants, Children (WIC) provides infants, at-risk, pregnant, postpartum individuals, low-income families. interventions insecurity.33 Table 2 examples evidence-based resources, eligibility, type rendered (federal, state, local). When implementing important consider barriers care, transportation, poor housing further potentiality insecurity.22, 34 elements environment structural racism propagate problem deserts exist.34 Eligibility vary programa America Affiliate Bankb https://www.feedingamerica.org/find-your-local-foodbank https://www.cdc.gov/nutrition/state-and-local-strategies/priority-incentives-prescriptions.html prescription implemented aims bring options members. By providing pharmacy commonly referred "food farmacy", postulated theory members will given healthy fruits vegetables.35 extremely undergo physiologic often deprive minerals affect person fetus. premise these offer some incentive whereby financial exchange vouchers offered qualified individuals. addition, Medicine (FIM) pilot program designed address mitigate chronic diseases.36 emerging benefits breastfeeding link prevention problems heart disease, FIM. FIM offers foods tailored individuals.36 intersection disease developmental phase. provided meals medically ability general groceries prescriptions fresh produce. Similarly, federal government Section 1115 granted waivers states enhance coverage Medicaid. touted demonstrate management, outcomes, return investments relating costs.36 Because relatively new beginning phases needed effectiveness, barriers, assess buy-in stakeholders. As providers, we must deserts, defined "when certain percentage county's population located 10 miles large retailer (supermarkets 50 employees, supercenters, wholesale clubs)."37 Access Atlas useful specific census tract level supermarket availability. Figure 1 represents Texas, 2019 Economic Service. map visual summary metrics tracts different measures proximity vehicle resource used clinicians identify practice areas (using zip code) understand needs clients. Atlas, Texas. atlas Texas made miles, 0.5 20 Abbreviations: LA, access; LI, low-income, USDA, Agriculture. aIndicates accessibility. another component following resources. designated staff member, worker, worker could tasked build your clinic's capacity insecurity.32 emphasis enhancing Sustainable Development Goals, accurate identification occurrence young crucial. critical life stages lead permanent effects. Women particularly vulnerable experiencing deep-rooted societal power imbalances various socioeconomic factors, instances intimate partner violence, employment opportunities, education.38 Researchers confirmed associations improvements however integrating Proper identifies allows providers aid patients through referrals public, assistance programs.32 guidelines recommend least once again period Sign.26, 31 knowledge local organizations, programs, banks key care.26 paucity literature screening, dedicated explore topic. focus interprofessional education, incorporating academic training warranted. authors interest disclose.

Language: Английский