458 - Food Insecurity Among Families of Infants with Antenatal Opioid Exposure

Poster Number: 458
Publication Number: 458.130

Stephanie L. Merhar, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Jamie E. Newman, RTI International, Carrboro, NC, United States; Scott A. Lorch, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Michele Walsh, NICHD, Bethesda, MD, United States; Namasivayam Ambalavanan, University of Alabama School of Medicine, Birmingham, AL, United States; Brenda Poindexter, Emory University and Children's Healthcare of Atlanta, Atlanta, GA, United States; Sara B. DeMauro, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Catherine Limperopoulos, Children's National Health System, Washington, DC, United States; Deanne Wilson-Costello, Rainbow Babies and Children's Hospital, Cleveland, OH, United States; Carla Bann, RTI International, Research Triangle Park, NC, United States

Background: Food insecurity, defined as limited or uncertain access to adequate food, affected 10.5% of the US population in 2020. Food insecurity is related to poorer health outcomes, including adverse physical and cognitive outcomes for affected children. Previous studies have suggested that infants whose mothers used opioids during pregnancy are more likely to require treatment for neonatal opioid withdrawal syndrome (NOWS) if their mothers also experienced food insecurity during pregnancy (Rose-Jacobs 2018).

Objective: To examine food insecurity in families of infants with antenatal opioid exposure and its relationship to other maternal and neonatal factors

Design/Methods: We included 82 infants and their caregivers enrolled in the Outcomes of Babies with Opioid Exposure study (NCT04149509). At the initial study visit before one month of age, caregivers were questioned about food insecurity and about the caregiver’s adverse childhood experiences (ACEs). We computed frequencies and percentages of responses to these items and used chi-square tests to compare factors among those who screened positive for food insecurity, defined as responding “sometimes true” or “often true” to “worried whether our food would run out before we got money to buy more” and/or “food we bought just didn’t last and we didn’t have money to get more”. Families who screened positive were provided referrals to local food resources and federal nutrition programs.

Results: About one-third (30.5%) of mothers of opioid-exposed infants screened positive for food insecurity. Screening positive for food insecurity was correlated with questions on the ACE questionnaire about caregiver experiences prior to age 18, including being “sworn at, insulted, put down, humiliated or act in a way to cause fear of being physically hurt” (p=0.04), “lived with someone who was a problem drinker or used drugs” (p=0.008), and “household member depressed or mentally ill or attempted suicide” (p=0.002). Food insecurity during pregnancy was not significantly associated with the infant’s birth weight, length or head circumference. Food insecurity was not associated with the infant receiving medication for NOWS (45% of infants with mothers with food insecurity received medication vs 27% of infants with mothers without food insecurity, p=0.12).Conclusion(s): Food insecurity was more frequent among families of infants with antenatal opioid exposure than the general population and was associated with exposure to adverse childhood experiences.
Table 1. Food Insecurity by Socio-Demographic Characteristics
Table 2. Food Insecurity and Neonatal Variables