Edwards, ToddMowe, Hadley2019-08-142019-08-142019Mowe_washington_0250O_20138.pdfhttp://hdl.handle.net/1773/44307Thesis (Master's)--University of Washington, 2019Background: There is a high prevalence of maternal anemia in the United States, despite continued efforts to promote intake of iron supplements during pregnancy. Public health researchers are recognizing that there may be broader socio-economic mechanisms behind maternal anemia. One of the potential factors researchers are beginning to explore is food insecurity. The current study aimed to test the association between food insecurity and maternal anemia. A secondary aim of this study was to explore the potential association between maternal anemia and other food insecurity related socio-economic factors – housing, transportation, and financial coverage of basic expenses. Methods: This study was conducted using a cross-sectional design and data collected from prenatal clinics within a Portland, Oregon healthcare system. Information from a total of 1,209 participants identified from among women attendants of prenatal clinics was obtained using patient intake forms and medical records. Associations between food insecurity and maternal anemia were evaluated using odds ratios (OR) and related 95% confidence intervals (CIs) from unadjusted and two adjusted logistic regression models. The first adjusted model included the following variables: race and ethnicity, parity, and age. The second adjusted model included all variables included in the first adjusted model as well as educational attainment, Medicaid/Medicare status, relationship status, planned pregnancy, and tobacco use. Similar models were used to examine associations of housing, transportation, and financial coverage of basic expenses with maternal anemia. Findings: Among study participants, 14.4% (n=165) of women were considered to be food insecure and 85.6% (n=981) were considered to be food secure. Overall, 35.6% (n=431) of women were considered anemic and 64.4% (n=778) were considered non-anemic. In the fully adjusted model, the odds of having maternal anemia were 1.56-fold higher (95% CI: 10.8-2.26) for women with food insecurity compared odds of having maternal anemia among food secure women. Conclusion: We found independent associations of food insecurity and food insecurity related socio-economic factors with maternal anemia. This study supports previous research that has demonstrated an association between food insecurity and maternal anemia. This study also expands on the literature by exploring the relationship between maternal anemia and additional socio-economic variables. The findings from this study can be used to inform future intervention strategies within Providence Health and Services prenatal clinics in Oregon.application/pdfen-USnonePublic healthHealth servicesThesis