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Health Equity/Community Health

Poster Session 2

(540) Exploring effects of meal supplementation on pregnancy outcomes amongst food insecure pregnant persons

Tuesday, February 13, 2024

3:30 PM – 5:00 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Lauren M. Murphy, MD

Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
Providence, RI, United States

Coauthor(s)

ST

Shana Talbot, MD

Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
Providence, RI, United States
LS

Lauren Schlichting, PhD

Hassenfeld Child Health and Innovation Institute of Brown University
Providence, RI, United States
SR

Swati Rajprohat, MD

Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
Providence, RI, United States
JL

Janet Lefkowitz, DO

Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
Providence, RI, United States
Adam K. Lewkowitz, MD, MPH

Assistant Professor
Warren Alpert Medical School of Brown University, Women & Infants Hospital Rhode Island
Providence, RI, United States

Objective: Pregnant people with food insecurity (FI) are at increased risk of adverse perinatal outcomes. A program providing free meals from Meals on Wheels (MoW) for pregnant people with FI was initiated at an urban academic clinic.

Study Design: The Hunger Vital SignTM was used to screen pregnant people for FI at their prenatal intake visit. All patients with FI were offered enrollment in MoW until delivery. From May 2023 to June 2023, perinatal outcomes were compared from those with FI who did versus did not enroll in the MoW and, among those who participated, those who disenrolled versus continued in MoW until delivery.

Results: Among 810 screened patients, 51 (6%) had FI. Of these, 57% (n=29) enrolled in the program and, of these, 18 (62%) received meals until delivery. There were no significant differences amongst those who did or did not enroll in MoW or amongst those enrolled and continued or discontinued MoW services. FI patients who did not enroll in MoW were more likely than those who did enroll to deliver at an earlier gestational age (37.71 vs 39.43 P< 0.01), but there was no difference in GA of delivery among those enrolled who did versus did not continue MoW until delivery. Those who were obese with FI (BMI 30-35) were more likely to remain within recommended weight gain if they were ever in MoW (14lbs vs 30lbs p< 0.04). The prevalence of gestational diabetes and preeclampsia was lower amongst those who received MoW compared to those who declined; this was not statistically significant. The prevalence of perinatal depression differed amongst FI pregnant patients who stayed in MoW (45.5%) versus those who disenrolled (38.9%) or who never enrolled (31.8%), but this difference did not achieve statistical significance.

Conclusion: A free meal delivery service is feasible in urban care perinatal clinics. Trends in this small cohort suggest this survey may improve perinatal outcomes. However, mixed methods data are needed to examine why ~40% of eligible participants declined enrollment and ~40% of enrolled patients disenrolled pre-delivery.