Journal of Nutrition,Fasting and Health

Journal of Nutrition,Fasting and Health

Prevalence of Household Food Insecurity and its Predictive Factors in Pregnant Women of Qazvin Province, Iran

Document Type : Research Paper

Authors
Farnoosh Moafi 1
Zainab Alimoradi 1
Elahe Farahani 2
Sahar Ebrahimi 2
Hamideh Hajnasiri 1
1 Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
2 Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran.
10.22038/jnfh.2025.87418.1577
Abstract
Introduction: The Iranian population faces heightened vulnerability to food insecurity due to multifaceted factors, including poverty, economic instability, climate change, and the protracted socioeconomic impacts of the COVID-19 pandemic. Pregnant women are particularly at risk, necessitating targeted assessments of this critical public health issue. This study aimed to determine the prevalence of food insecurity and its predictors among pregnant women in Qazvin, Iran. Methods: A cross-sectional study was conducted in Qazvin from 2022 to 2023, enrolling 422 healthy pregnant women attending comprehensive health centers. Data were collected using a researcher-developed checklist for sociodemographic and obstetric characteristics, while food insecurity was assessed via the Household Food Insecurity Access Scale (HFIAS). Logistic regression analysis identified predictors (P < 0.05). Results: Food insecurity prevalence reached 71.4% (95% CI: 66.89-75.51), with 48.9% moderate-to-severe food insecurity. In adjusted analyses, rural residence (OR: 0.20; P: 0.015), smoking (OR: 0.20; P = 0.041), and hookah consumption (OR: 0.29; P: 0.001) were significantly associated with lower food security. Conversely, family income status at the level of savings (OR: 25.10; P< 0.001) and sufficient (OR: 5.18; P< 0.001), supplemental health insurance coverage (OR: 2.05; P: 0.006), and higher maternal education levels (OR: 1.96; P: 0.012) correlated with increased probability of food security. Conclusion: Food insecurity is prevalent among pregnant women in Qazvin, disproportionately affecting rural populations, those with lower education, inadequate income, lack of supplemental insurance, and substance use (smoking/hookah). Intervention programs should prioritize these high-risk groups to mitigate nutritional disparities.
Keywords
Prevalence
Pregnancy
Food insecurity
Subjects
  1. Jensen L. The sustainable development goals report. New York: United Nations; 2020.
  2. Bickel G, Nord M, Price C, Hamilton W, Cook J. Guide to Measuring Household Food Security, Revised 2000. USDA. 2000.
  3. Hanson KL, Connor LM. Food insecurity and dietary quality in US adults and children: a systematic review. Am J Clin Nutr. 2014;100(2):684-92.
  4. Matheson J, McIntyre L. Women respondents report higher household food insecurity than do men in similar Canadian households. Public Health Nutr. 2014;17(1):40-8.
  5. Arzhang P, Abbasi SH, Sarsangi P, et al. Prevalence of household food insecurity among a healthy Iranian population: A systematic review and meta-analysis. Frontiers in Nutrition. 2022;9: 1006543.
  6. Augusto AL, de Abreu Rodrigues AV, Domingos TB, Salles-Costa R. Household food insecurity associated with gestacional and neonatal outcomes: a systematic review. BMC Pregnancy Childbirth. 2020;20(1):229.
  7. Laraia BA, Siega-Riz AM, Gundersen C, Dole N. Psychosocial factors and socioeconomic indicators are associated with household food insecurity among pregnant women. J Nutr. 2006;136(1):177-82.
  8. Laraia B, Epel E, Siega-Riz AM. Food insecurity with past experience of restrained eating is a recipe for increased gestational weight gain. Appetite. 2013;1(65):178-84.
  9. Laraia BA, Siega-Riz AM, Gundersen C. Household food insecurity is associated with self-reported pregravid weight status, gestational weight gain, and pregnancy complications. J Am Diet Assoc. 2010;110(5):692-701.
  10. Borders AE, Grobman WA, Amsden LB, Holl JL. Chronic stress and low birth weight neonates in a low-income population of women. Obstet Gynecol. 2007;109(2 Part 1): 331-8.
  11. Carmichael SL, Yang W, Herring A, Abrams B, Shaw GM. Maternal food insecurity is associated with increased risk of certain birth defects. J Nutr. 2007;137(9):2087-92.
  12. Askari E, Dehkordi FR, Mokhayeri Y, Amraei M, Behzadifar M, Imani-Nasab MH. Food Insecurity among Iranian Pregnant Women: A Systematic Review and Meta-Analysis. IJNMR. 2024;29(4):403-10.
  13. Alimoradi Z, Kazemi F, Estaki T, Mirmiran P. Household food security in Iran: systematic review of Iranian articles. Adv Nurs Midwifery. 2015;24(87):63–76.
  14. Iqbal S, Ali I. Maternal food insecurity in low-income countries: Revisiting its causes and consequences for maternal and neonatal health. J Agric Food Res. 2021; 3: 100091.
  15. Ghalibaf M, Gholami M, Ahmadi S. Climate change, food system, and food security in Iran. Journal of Agricultural Science and Technology. 2023; 25(1):1-17.
  16. Quandt A. Coping with drought: Narratives from smallholder farmers in semi-arid Kenya. International Journal of Disaster Risk Reduction. 2021; 57: 102168.
  17. Aggarwal P, Singh A. Implications of global climatic change on water and food security. Global change: Impacts on water and food security: Springer. 2009.
  18. Hou L, Min S, Huang Q, Huang J. Farmers' perceptions of drought-severity and the impacts on ex-ante and ex-post adaptations to droughts: Evidence from maize farmers in China. Agricultural Water Management. 2023;279: 108180.
  19. Ataei P, Sadighi H, Izadi N. Major challenges to achieving food security in rural, Iran. Rural Society. 2021;30(1):15-31.
  20. Kazemi F, Moafi F, Siboni FS, Alimoradi Z. Prevalence and predictors of food insecurity among pregnant women: a cross sectional study in Qazvin Province, Iran. Midwifery. 2018;66: 25-9.
  21. Zinga J, McKay FH, Lindberg R, van der Pligt P. Experiences of food-insecure pregnant women and factors influencing their food choices. Matern Child Health J. 2022;26(7): 1434-41.
  22. Rivington M, King R, Duckett D, et al. UK food and nutrition security during and after the COVID‐19 pandemic. Nutr Bull. 2021;46(1):88-97.
  23. Salarkia N, Abdollahi M, Amini M, Eslami Amirabadi M. Validation and use of the HFIAS questionnaire for measuring household food insecurity in Varamin-2009. IJEM. 2011;13(4):374-83.
  24. Kleve S, Bennett CJ, Davidson ZE, et al. Food insecurity prevalence, severity and determinants in australian households during the COVID-19 pandemic from the perspective of women. Nutrients. 2021;13(12):4262.
  25. Rad AK, Shamshiri RR, Azarm H, Balasundram SK, Sultan M. Effects of the COVID-19 pandemic on food security and agriculture in Iran: a survey. Sustainability. 2021;13(18):10103.
  26. Coleman-Jensen A, Rabbitt MP, Gregory CA, Singh A. Household food security in the United States in 2018. Economic Research Report. 2019;270.
  27. DeWitt E, Gillespie R, Norman-Burgdolf H, Cardarelli KM, Slone S, Gustafson A. Rural SNAP participants and food insecurity: how can communities leverage resources to meet the growing food insecurity status of rural and low-income residents?. Int J Environ Res Public Health. 2020;17(17):6037.
  28. Turner JH. Theoretical sociology: a concise introduction to twelve sociological theories. Los Angeles: SAGE Publications; 2013.
  29. Demétrio F, Teles CA, Santos DB, Pereira M. Food insecurity in pregnant women is associated with social determinants and nutritional outcomes: a systematic review and meta-analysis. Cien Saude Colet. 2020;25: 2663-76.
  30. Sullivan K, St John M, DeFranco E, Kelly E. Food insecurity in an urban pregnancy cohort. Am J Perinatol. 2023;40(1):57-61.
  31. Broussard NH. What explains gender differences in food insecurity?. Food Policy. 2019;83: 180-94.
  32. Grimaccia E, Naccarato A. Food insecurity in Europe: A gender perspective. Soc Indic Res. 2022;161(2):649-67.
  33. Dean EB, French MT, Mortensen K. Food insecurity, health care utilization, and health care expenditures. Health Serv Res. 2020;55: 883-93.
  34. Guo B. Household assets and food security: Evidence from the survey of program dynamics. JFEI. 2011;32: 98-110.
  35. Chang Y, Chatterjee S, Kim J. Household finance and food insecurity. JFEI. 2014;35:499-515.
  36. Johnson KT, Palakshappa D, Basu S, Seligman H, Berkowitz SA. Examining the bidirectional relationship between food insecurity and healthcare spending. Health Serv Res. 2021;56(5):864-73.
  37. Bertoldo J, Wolfson JA, Sundermeir SM, et al. Food insecurity and delayed or forgone medical care during the COVID-19 pandemic. Am J Public Health 2022;112(5):776-85.
  38. Farrelly MC, Shafer PR. Comparing trends between food insecurity and cigarette smoking among adults in the United States, 1998 to 2011. Am J Health Promot. 2017;31(5):413-6.
  39. Poghosyan H, Moen EL, Kim D, Manjourides J, Cooley ME. Social and structural determinants of smoking status and quit attempts among adults living in 12 US states, 2015. Am J Health Promot. 2019;33(4):498-506.
  40. Hunt BR, Whitman S. Maternal smoking in Chicago: a community-level analysis. J Health Care Poor Underserved. 2011;22(1):194-210.
  41. Martin LT, McNamara M, Milot A, Bloch M, Hair EC, Halle T. Correlates of smoking before, during, and after pregnancy. Am J Health Behav. 2008;32(3):272-82.
  42. Wakschlag LS, Pickett KE, Middlecamp MK, Walton LL, Tenzer P, Leventhal BL. Pregnant smokers who quit, pregnant smokers who don’t: does history of problem behavior make a difference?. Soc Sci Med. 2003;56(12):2449-60.
Journal of Nutrition,Fasting and Health
Volume 14, Issue 2
Spring 2026
Pages 94-101

  • Receive Date 13 April 2025
  • Revise Date 08 June 2025
  • Accept Date 11 June 2025