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. 2018 Apr;53(4):363-372.
doi: 10.1007/s00127-018-1497-y. Epub 2018 Feb 14.

Factors associated with household food insecurity and depression in pregnant South African women from a low socio-economic setting: a cross-sectional study

Zulfa Abrahams  1 , Crick Lund  2   3 , Sally Field  4 , Simone Honikman  4
Affiliations

Factors associated with household food insecurity and depression in pregnant South African women from a low socio-economic setting: a cross-sectional study

Zulfa Abrahams et al. Soc Psychiatry Psychiatr Epidemiol. 2018 Apr.

Abstract

Purpose: Food insecurity has been linked with maternal depression in low-income settings. Few studies have looked at factors associated with both food insecurity and maternal depression as outcomes. This study aimed to assess factors associated with food insecurity and depression in a sample of pregnant South African women.

Methods: We conducted a cross-sectional study at a Midwife Obstetric Unit in a low-income suburb in Cape Town. Pregnant women attending the clinic for their first antenatal visit were invited to participate. The shortened form of the US Household Food Security Survey Module was used to measure food insecurity. The Expanded Mini-International Neuropsychiatric Interview was used to diagnose depression, anxiety, alcohol and drug dependence, and assess for suicidal ideation and behaviour. Logistic regression modelling was conducted to explore factors associated with food insecurity and depression in separate models.

Results: We found that 42% of households were food insecure and that 21% of participants were depressed (N = 376). The odds of being food insecure were increased in women with suicidal behaviour (OR = 5.34; 95% CI 1.26-22.57), with depression (4.27; 1.43-12.70) and in those with three or more children (3.79; 1.25-11.55). The odds of depression was greater in women who were food insecure (5.30; 1.63-17.30), substance dependent (15.83; 1.31-191.48) or diagnosed with an anxiety disorder (5.04; 1.71-14.82).

Conclusions: Food insecurity and depression are strongly associated in pregnant women. The relationship between food insecurity and depression is complex and requires further investigation. Interventions that improve both food security and mental health during the perinatal period are likely to benefit the physical and mental well-being of mothers and children.

Keywords: Anxiety; Depression; Food insecurity; Low-resource settings; Pregnant; Suicidality.

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Conflict of interest statement

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical statement

This study was approved by the University of Cape Town Human Research Ethics Committee (HREC REF: 131/ 2009). Study participants were 18 years and older, and written informed consent was sought before data collection.

References

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