The Relationship Between Diet Quality, Residing in a Food Desert, and Psychosocial Characteristics in Early Pregnancy

Background: Access to high quality nutrition is an important part of a healthy pregnancy, and multiple risk factors for poor maternal nutrition have been identified. Objective: The objective of this study was to examine the relationship between self-reported diet quality and residing in a food desert during early pregnancy. Secondary outcomes included examining the relationship between diet quality and measures of antenatal depression and stress during early pregnancy. Study Design: This study is a secondary analysis of data collected in the Hoosier Moms Cohort study. Diet quality was based on patient self-report via the Automated Self-Administered 24-Hour Dietary Assessment Tool and food deserts were defined based on the USDA Food Access Research Atlas. Comparisons of food quality tertile with participant demographics and living in a food desert were performed using chi-square tests for categorical variables and ANOVA for continuous variables. Results: A total of 242 participants were included in this analysis and 37.3% resided in a food desert. Obese (p=0.0007) and younger (p < 0.0001) participants were more likely to be in the lowest diet quality tertile. Residing in a food desert was not associated with poor diet quality (p= 0.06). Higher antenatal depression scores were noted in the lowest diet quality tertile (p= 0.049). Compared to participants in highest diet quality tertiles, those in the lowest tertile were independently associated with age (OR 0.86, 95%CI 0.80-0.92) and obesity (OR 3.81, 95%CI 1.76-8.24). Adding food deserts into the model did not substantially change those estimates, while residing in a food desert was not associated with lowest diet quality tertiles (OR 1.09, 95% CI 0.55-2.15). Conclusion: Residing in a food desert was not found to be independently associated with diet quality in early pregnancy. Lower maternal age and pre-pregnancy obesity were associated with poorer diet quality in early pregnancy.