Risk factors for food insecurity and association with prenatal care utilization among women who took opioids during pregnancy and unexposed controls

Abstract Background Food insecurity during pregnancy is associated with poorer outcomes for both mothers and their newborns. Given the ongoing opioid crisis in the United States, mothers who take opioids during pregnancy may be at particular risk of experiencing food insecurity. Methods This researc...

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Main Authors: Lindsay M. Parlberg, Jamie E. Newman, Stephanie L. Merhar, Brenda Poindexter, Sara B. DeMauro, Scott A. Lorch, Myriam Peralta-Carcelen, Deanne E. Wilson-Costello, Namasivayam Ambalavanan, Catherine Limperopoulos, Nicole Mack, Jonathan M. Davis, Michele C. Walsh, Carla M. Bann, on behalf of the ACT NOW OBOE Study Consortium
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Pregnancy and Childbirth
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Online Access:https://doi.org/10.1186/s12884-025-07499-y
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author Lindsay M. Parlberg
Jamie E. Newman
Stephanie L. Merhar
Brenda Poindexter
Sara B. DeMauro
Scott A. Lorch
Myriam Peralta-Carcelen
Deanne E. Wilson-Costello
Namasivayam Ambalavanan
Catherine Limperopoulos
Nicole Mack
Jonathan M. Davis
Michele C. Walsh
Carla M. Bann
on behalf of the ACT NOW OBOE Study Consortium
author_facet Lindsay M. Parlberg
Jamie E. Newman
Stephanie L. Merhar
Brenda Poindexter
Sara B. DeMauro
Scott A. Lorch
Myriam Peralta-Carcelen
Deanne E. Wilson-Costello
Namasivayam Ambalavanan
Catherine Limperopoulos
Nicole Mack
Jonathan M. Davis
Michele C. Walsh
Carla M. Bann
on behalf of the ACT NOW OBOE Study Consortium
author_sort Lindsay M. Parlberg
collection DOAJ
description Abstract Background Food insecurity during pregnancy is associated with poorer outcomes for both mothers and their newborns. Given the ongoing opioid crisis in the United States, mothers who take opioids during pregnancy may be at particular risk of experiencing food insecurity. Methods This research utilized data from 254 biological mothers of infants in the Advancing Clinical Trials in Neonatal Opioid Withdrawal Syndrome (ACT NOW) Outcomes of Babies with Opioid Exposure (OBOE) Study. We examined factors associated with food insecurity among mothers of infants with antenatal opioid exposure and their unexposed (control) counterparts. Chi-square tests and logistic regression were used to compare food insecurity by sociodemographic characteristics, opioid use, prior traumatic experiences, and housing instability. Similar analyses were conducted to examine the relationship between food insecurity during pregnancy and receipt of adequate prenatal care. Results Overall, 58 (23%) of the mothers screened positive for food insecurity. Prevalence of food insecurity was higher among mothers who took opioids during pregnancy compared to controls (28% vs. 14%; p = 0.007). However, the difference between the two groups was no longer significant after accounting for demographics, housing instability, and prior trauma (AOR (95% CI) = 1.85 (0.82, 4.20), p = 0.140). Mothers with food insecurity during pregnancy were less likely to have received adequate prenatal care (78% vs. 90%), after controlling for other factors (AOR (95% CI) = 0.39 (0.16, 1.00), p = 0.049). Conclusions Food insecurity frequently co-occurred with housing instability and prior trauma among mothers of infants with antenatal opioid exposure, for which limited data are available. Although those with food insecurity are at increased risk for poor pregnancy outcomes, they were less likely to have received adequate prenatal care despite high levels of public insurance coverage, suggesting alternative approaches are needed to address barriers to healthcare among this population. Wrap-around care models are recommended to provide multifaceted and continuous support during the perinatal period. Care models should provide for staff training in trauma-informed care and include resources to address housing and food concerns. Trial registration The Outcomes of Babies with Opioid Exposure (OBOE) Study is registered at Clinical Trials.gov (NCT04149509) (04/11/2019).
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spelling doaj-art-c0cda09bd939425cb44bbaf26fbe38f72025-08-20T01:54:22ZengBMCBMC Pregnancy and Childbirth1471-23932025-04-012511910.1186/s12884-025-07499-yRisk factors for food insecurity and association with prenatal care utilization among women who took opioids during pregnancy and unexposed controlsLindsay M. Parlberg0Jamie E. Newman1Stephanie L. Merhar2Brenda Poindexter3Sara B. DeMauro4Scott A. Lorch5Myriam Peralta-Carcelen6Deanne E. Wilson-Costello7Namasivayam Ambalavanan8Catherine Limperopoulos9Nicole Mack10Jonathan M. Davis11Michele C. Walsh12Carla M. Bann13on behalf of the ACT NOW OBOE Study ConsortiumRTI InternationalRTI InternationalCincinnati Children’s Hospital Medical Center, University of Cincinnati College of MedicineEmory UniversityChildren’s Hospital of PhiladelphiaChildren’s Hospital of PhiladelphiaUniversity of Alabama at BirminghamCase Western Reserve UniversityUniversity of Alabama at BirminghamChildren’s National Medical CenterRTI InternationalTufts Medical CenterEunice Kennedy Shriver National Institute of Child Health and Human DevelopmentRTI InternationalAbstract Background Food insecurity during pregnancy is associated with poorer outcomes for both mothers and their newborns. Given the ongoing opioid crisis in the United States, mothers who take opioids during pregnancy may be at particular risk of experiencing food insecurity. Methods This research utilized data from 254 biological mothers of infants in the Advancing Clinical Trials in Neonatal Opioid Withdrawal Syndrome (ACT NOW) Outcomes of Babies with Opioid Exposure (OBOE) Study. We examined factors associated with food insecurity among mothers of infants with antenatal opioid exposure and their unexposed (control) counterparts. Chi-square tests and logistic regression were used to compare food insecurity by sociodemographic characteristics, opioid use, prior traumatic experiences, and housing instability. Similar analyses were conducted to examine the relationship between food insecurity during pregnancy and receipt of adequate prenatal care. Results Overall, 58 (23%) of the mothers screened positive for food insecurity. Prevalence of food insecurity was higher among mothers who took opioids during pregnancy compared to controls (28% vs. 14%; p = 0.007). However, the difference between the two groups was no longer significant after accounting for demographics, housing instability, and prior trauma (AOR (95% CI) = 1.85 (0.82, 4.20), p = 0.140). Mothers with food insecurity during pregnancy were less likely to have received adequate prenatal care (78% vs. 90%), after controlling for other factors (AOR (95% CI) = 0.39 (0.16, 1.00), p = 0.049). Conclusions Food insecurity frequently co-occurred with housing instability and prior trauma among mothers of infants with antenatal opioid exposure, for which limited data are available. Although those with food insecurity are at increased risk for poor pregnancy outcomes, they were less likely to have received adequate prenatal care despite high levels of public insurance coverage, suggesting alternative approaches are needed to address barriers to healthcare among this population. Wrap-around care models are recommended to provide multifaceted and continuous support during the perinatal period. Care models should provide for staff training in trauma-informed care and include resources to address housing and food concerns. Trial registration The Outcomes of Babies with Opioid Exposure (OBOE) Study is registered at Clinical Trials.gov (NCT04149509) (04/11/2019).https://doi.org/10.1186/s12884-025-07499-yFood insecurityHousing instabilityAntenatal opioid exposureSocial determinants of health
spellingShingle Lindsay M. Parlberg
Jamie E. Newman
Stephanie L. Merhar
Brenda Poindexter
Sara B. DeMauro
Scott A. Lorch
Myriam Peralta-Carcelen
Deanne E. Wilson-Costello
Namasivayam Ambalavanan
Catherine Limperopoulos
Nicole Mack
Jonathan M. Davis
Michele C. Walsh
Carla M. Bann
on behalf of the ACT NOW OBOE Study Consortium
Risk factors for food insecurity and association with prenatal care utilization among women who took opioids during pregnancy and unexposed controls
BMC Pregnancy and Childbirth
Food insecurity
Housing instability
Antenatal opioid exposure
Social determinants of health
title Risk factors for food insecurity and association with prenatal care utilization among women who took opioids during pregnancy and unexposed controls
title_full Risk factors for food insecurity and association with prenatal care utilization among women who took opioids during pregnancy and unexposed controls
title_fullStr Risk factors for food insecurity and association with prenatal care utilization among women who took opioids during pregnancy and unexposed controls
title_full_unstemmed Risk factors for food insecurity and association with prenatal care utilization among women who took opioids during pregnancy and unexposed controls
title_short Risk factors for food insecurity and association with prenatal care utilization among women who took opioids during pregnancy and unexposed controls
title_sort risk factors for food insecurity and association with prenatal care utilization among women who took opioids during pregnancy and unexposed controls
topic Food insecurity
Housing instability
Antenatal opioid exposure
Social determinants of health
url https://doi.org/10.1186/s12884-025-07499-y
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