Food Insecurity among Iranian Pregnant Women: A Systematic Review and Meta-Analysis

Elaheh Askari, Fatemeh Raeesi Dehkordi, Yaser Mokhayeri, Morteza Amraei, Masoud Behzadifar, Mohammad Hasan Imani Nasab

Abstract


Abstract

Background: Estimating the prevalence of food insecurity among vulnerable sub‑groups, especially pregnant women, is significant. This study aimed to estimate the pooled prevalence of food insecurity among Iranian pregnant women and to determine its related factors.

Materials and Methods: This study constitutes a systematic review and meta‑analysis of cross‑sectional studies involving pregnant women, published between January 2000 and September 2022, in English and Persian on seven databases. Finally, 14 studies were analyzed and synthesized, with the results presented in the form of forest plots. Heterogeneity was investigated using the I2 index and the meta‑regression to evaluate variables suspected of causing heterogeneity. Statistical analysis and synthesis were performed using Stata‑16.

Results: The pooled prevalence of food insecurity among Iranian pregnant women was 45% (95% confidence interval: 37–54%). In a multi‑variable meta‑regression model, p values were significant for the year of data collection and the type of the questionnaire. The adjusted I2 and R2 indices were estimated at 84.47 and 51.46%, respectively. The prevalence of food insecurity among Iranian pregnant women has been estimated at half a million.

Conclusions: Given the high prevalence of food insecurity among pregnant women in Iran, we propose the inclusion of food insecurity screening for this vulnerable demographic within the primary healthcare package. Additionally, we advocate for the allocation of food subsidies to pregnant women confronting food insecurity.



Keywords


Food insecurity, food security, Iran, meta‑analysis, pregnant women, prevalence, systematic review

Full Text:

PDF

References


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.

IFAD, UNICEF, WFP, WHO. The State of Food Security and Nutrition in the World 2022. Repurposing food and agricultural policies to make healthy diets more affordable. FAO Rome, Italy; 2022.

Dolatian M, Sharifi N, Mahmoodi Z. Relationship of socioeconomic status, psychosocial factors, and food insecurity with preterm labor: A longitudinal study. Int J Reprod Biomed 2018;16:563-70.

Ezzeddin N, Jahanihashemi H, Zavoshy R, Noroozi M. The prevalence of postpartum depression and its association with food insecurity among mothers referring to community health centers. Iran J Psychiatry 2018;13:280-7.

Moafi F, Kazemi F, Samiei Siboni F, Alimoradi Z. The relationship between food security and quality of life among pregnant women. BMC Pregnancy Childbirth 2018;18:319.

Lokhande TN, Varma KS, Gharate SM, Mahajan SK, Surana KR. Vitamins as nutraceuticals for pregnancy. Vitamins as Nutraceuticals: Recent Advances and Applications. Wiley Online Library; 2023. p. 185-204.

Ivers LC, Cullen KA. Food insecurity: Special considerations for women. Am J Clin Nutr 2011;94:1740S-4S.

Augusto ALP, 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;20:1-11.

Mohammadi Nasrabadi F, Omidvar N, Khoshfetrat M, Kolahdooz F. Household food insecurity in the Islamic Republic of Iran: A systematic review and meta-analysis. East Mediterr Health J 2014;20:698-706.

Pedroso J, Buccini G, Venancio SI, Pérez-Escamilla R, Gubert MB. Maternal mental health modifies the association of food insecurity and early child development. Matern Child Nutr 2020;16:e12997.

Behzadifar M, Behzadifar M, Abdi S, Malekzadeh R, Salmani MA, Ghoreishinia G, et al. Prevalence of food insecurity in Iran: A systematic review and meta-analysis. Arch Iran Med 2016;19:288-94.

Alikamali M, Khodabandeh S, Motesaddi M, Bagheri Z, Esmaeili MA. The Association between demographic characteristics and attempting of pregnancy with postpartum depression and anxiety among women referring to community health centres: A Cross sectional study. Malays J Med Sci 2020;27:93-104.

Kazemi F, Masoumi SZ, Shayan A, Yasaghi SZS. Prevalence of food insecurity in pregnant women and its association with gestational weight gain pattern, neonatal birth weight, and pregnancy complications in Hamadan County, Iran, in 2018. Agric Food Secur 2020;9:1-8.

Panic N, Leoncini E, de Belvis G, Ricciardi W, Boccia S. Evaluation of the endorsement of the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement on the quality of published systematic review and meta-analyses. PLoS One 2013;8:e83138.

The Central Bank of Iran. Household Budget Survey In Urban Areas in Iran. Available from: https://www.cbi.ir/simplelist/1421.aspx. [Last accessed on 2023 Jan 16].

The Central Bank of Iran. Foreign Exchange Rates. Available from: https://www.cbi.ir/ExRates/rates_en.aspx. [Last accessed on 2023 Jan 16].

National Organization for Civil Registration of Iran. Crude Birth Rate of Iran. Available from: https://www.sabteahval.ir. [Last accessed on 2023 Jan 16].

Rasty R, Pouraram H, Heshmat R. Food insecurity and some demographic and socioeconomic characteristics, fertility, and pregnancy in women with planned and unplanned pregnancy. Iran J Epidemiol 2015;11:34-42.

Fathi Beyranvand H, Eghtesadi S, Ataie-Jafari A, Movahedi A. Prevalence of food insecurity in pregnant women in khorramabad city and its association with general health and other factors. Iran J Nutr Sci Food Technol 2019;14:21-30.

Hojaji E, Zavoshy R, Noroozi M, Jahanihashemi H. Assessment of household food security and its relationship with some pregnancy complications. J Mazandaran Univ Med Sci 2015;25:87-98.

Karbin K, Khorramrouz F, Farkhani EM, Sobhani SR, Mosalmanzadeh N, Shahriari Z, et al. Household food insecurity during pregnancy as a predictor of anthropometric indices failures in infants aged less than 6 months: a retrospective longitudinal study. Public Health Nutrition. 2022;25:1005-12.

Kazemi F, Moafi F, Samiei Siboni F, Alimoradi Z. Prevalence and predictors of food insecurity among pregnant women: A cross sectional study in Qazvin Province, Iran. Midwifery 2018;66:25-9.

Khoshgoo M, Eslami O, Al-Hosseini MK, Shidfar F. The relationship between household food insecurity and depressive symptoms among pregnant women: A cross sectional study. Iran J Psychiatry 2020;15:126-33.

Rajizadeh A, Tavakoli M, Hajipour M, Rabiey-Faradonbeh M, Salehi-Abargouei A, Bonab AM, et al. Food security status of pregnant women in Yazd, Iran, 2014-2015. J Nutr Food Secur 2019;4:152-60.

Hoseini KS, Kazemi F, Alimoradi Z, Oskoei SSS, Alijani H, Zolghadr S. Association between household food security and pregnancy complications. Soc Health Behav 2018;1:26-30.

Sharifi N, Dolatian M, Mahmoodi Z, Mohammadi-Nasrabadi F, Mehrabi Y. The relationship between structural social determinants of health and food insecurity among pregnant women. Iran Red Crescent Med J 2018;20:1-8 (In Press).

Sayehmiri K, Ebtekar F, Zarei M, Gheshlagh RG. Prevalence of unwanted pregnancy among Iranian women: An updated meta-analysis. BMC Pregnancy Childbirth 2019;19:1-7.

Demétrio F, Teles CAS, Santos DBD, 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.

Alimoradi Z, Kazemi F, Estaki T, Mirmiran P. Household food security in Iran: Systematic review of Iranian articles. Adv Nurs Midwifery 2015;24:63-76.

Hejazi J, Emamgholipour S. The effects of the re-imposition of US sanctions on food security in Iran. Int J Health Policy Manag 2022;11:651–7.


Refbacks

  • There are currently no refbacks.