319 - Program addressing maternal food insecurity and its relation to maternal and infant diet quality: Initial findings from the Maternal Well-Being Study

Poster Number: 319
Publication Number: 319.1978

Background: Medically tailored meals (MTM) are an emerging intervention for adults with food insecurity (FI) (limited or uncertain access to nutritious food due to cost). We adapted MTM programs to create MamaMeals (a novel, home-delivered meal program) and MamaMeals+ (MamaMeals with mental health support) tailored for mothers in their first 12 weeks postpartum (Figure 1).

Objective: To explore the association of MamaMeals or MamaMeals+ with improved maternal diet quality and breastfeeding at 12 weeks postpartum.

Design/Methods: The Maternal Well-Being Study is an ongoing, prospective quasi-randomized controlled trial. Pregnant women >/= 18 years, > 20 weeks gestation, English-speaking, and eligible for Medicaid, WIC or SNAP were included. Those with severe food allergy, celiac disease, inflammatory bowel disease, short bowel syndrome, anorexia nervosa, history of postpartum psychosis were excluded. Sixty-four mothers enrolled; 3 dropped out/withdrew prior to group assignment. Participants were assigned to Group A (MamaMeals Only), Group B (MamaMeals+), or Group C (Waitlist Control) using a pre-set block scheme. Analysis proceeded according to the intention-to-treat approach. Bivariate statistics examined differences in baseline characteristics and outcomes: maternal diet quality measured by the short form Healthy Eating Index (sHEI), breastfeeding status, and Edinburgh postnatal depression scale (EPDS) scores at the primary endpoint.

Results: Data from 61 mothers and 62 infants were analyzed with a median maternal age of 26. Self-identified maternal race and/or ethnicity was White, non-Hispanic (43%), Hispanic of any race (37%), Black, non-Hispanic (10%), and other (10%). Baseline characteristics were similar for groups except for WIC participation which was more common in the waitlist control group (Group C) compared to the two intervention groups (Table 1). At 12 weeks postpartum, median EPDS scores did not differ across groups (Table 2). Maternal diet quality differed with significantly higher mean sHEI subscale scores related to whole grains in Group A (5.15 ± 1.92) and Group B (5.10 ± 1.52) vs. Group C (3.41 ± 2.73), p< 0.05. Weekly fish consumption was higher in Group A (71%) vs. Group B (39%) and Group C (18%), p< 0.01. No differences were found in breastfeeding at 12 weeks in Groups A (61%) and B (61%) vs. Group C (45%), p=0.594.

Conclusion(s): Home-delivered, nutritious meals for mothers may relate to improved diet quality. Continued analysis is needed to examine whether MamaMeals impacted breastfeeding and downstream infant nutrition.