the association between household food insecurity and preterm birth: a population-based case-control study using electronic records

Background & aim: preterm birth is a leading cause of infant morbidity and mortality worldwide. previous studies have linked household food insecurity to preterm birth and adverse maternal health outcomes, but population-based evidence is limited. this study examines the association between household food security and preterm birth among mothers in mashhad, iran.methods: a case-control study using electronic health records from the sina healthcare database at mashhad university of medical sciences was conducted. the study included 2,431 mothers with preterm births and an equal number of mothers with term deliveries, selected through random sampling (march 2019–march 2022). food security over the past 12 months was assessed using a validated household questionnaire. logistic regression analyses determined associations between food insecurity and preterm birth.results: mothers from food-insecure households had three times higher adjusted odds of preterm birth (aor 3.10; 95% ci 2.37-4.05, p < 0.001) compared to mothers from food-secure households. other significant risk factors included preeclampsia (aor 1.97; 95% ci 1.22-3.18, p = 0.005), gestational diabetes (aor 5.95; 95% ci 3.03-11.68, p < 0.001), and low birth weight (aor 47.27; 95% ci 35.01-63.82, p < 0.001). conclusion: household food insecurity was strongly associated with an increased risk of preterm birth, even after adjusting for medical and social factors. improving food security during pregnancy could reduce preterm birth rates and improve maternal and neonatal health outcomes.