Poster Topical Area: Community and Public Health Nutrition

Location: Auditorium

Poster Board Number: 45

P06-024 - Food Insecurity is Positively Associated with Infant Morbidity Symptoms at Three Months of Age in Nyanza, Kenya

Monday, Jun 11
8:00 AM – 3:00 PM

Objectives: Food insecurity (FI) has been associated with higher rates of child morbidity. However, this relationship has not been explored in the context of HIV-exposed infants. Thus, we characterized associations between maternal FI and respiratory, fever, and gastrointestinal (GI) morbidity in HIV-exposed and -unexposed infants in Nyanza, Kenya to understand the relative strength of the association between FI and other known predictors of morbidity.

Methods: At three months postpartum, we surveyed 302 HIV-infected and -uninfected women participating in an observational longitudinal study (Pith Moromo, NCT02974972) on maternal and infant respiratory (cough, difficulty breathing, runny nose), GI (diarrhea, vomiting), and febrile morbidities in the prior 48 hours. We also assessed Individual Food Insecurity (IFIAS: 0-27) and Health-Related Quality of Life (HRQL: 0-40) amongst other health and sociodemographic characteristics. Backward stepwise multivariate logistic regression models (cutoff: p<0.2) were built by morbidity type, retaining maternal HIV status.

Results: Due to missing data, 45 infants were excluded. Of those remaining, 30%, 14%, and 7% showed at least one respiratory, fever, or GI symptom, respectively. In multivariate models (Table 1), maternal FI was significantly positively associated with infant respiratory (aOR=1.07, p=0.02) and febrile (aOR=1.08, p<0.01) morbidities and marginally so with GI morbidity (aOR=1.04, p=0.10). Maternal morbidity was also a significant predictor of infant morbidity. Maternal respiratory morbidity was associated with infant respiratory morbidity (aOR=7.54, p<0.01), and general maternal morbidity was associated with infant febrile (aOR=2.32, p<0.01) and GI (aOR=1.94, p=0.02) morbidities. Peri-urban residence was associated with higher respiratory (aOR=3.10, p=0.01) and lower febrile (aOR=0.44, p=0.01) infant morbidities. Lower maternal quality of life was associated with infant GI morbidity (aOR=0.95, p=0.03).

Conclusion: For each 1-point increase in maternal FI, an infant was 7% and 8% more likely to experience respiratory and febrile morbidities, respectively. This was of larger impact than HIV-exposure. Interventions to improve infant morbidity should consider FI as an underlying contributor to maternal and infant health.

Funding Source:

NIH-NIMH K01 MH098902

Table 1: Multivariate logistic regressions for each morbidity class in three-month-olds in Western Kenya all show significant or marginally significant deleterious associations with maternal food insecurity score, and some show significant deleterious associations with maternal morbidity, low maternal quality of life, and peri-urban residence (n=257).

CoAuthors: Marianne Santoso, M.S. – Cornell University; Joshua Miller, B.S. – Northwestern University; Shalean Collins, MPH – Northwestern University; Godfred Boateng, MPhil, PhD – Northwestern University; Maricianah Onono, MBChB, MSc – University of California, San Francisco; Sera Young, M.A., Ph.D. – Northwestern University

Kathleen A. Clark

Northwestern University
Evanston, Illinois