Table 1.
Summary of included studies’ characteristics.
| First author, year | Country | Study Design | Age (range or mean) | Gestational age (range or mean) | Sample size (n) | Exposure | Measure of exposure | Cut‐off exposure | Outcome | Measure of Outcome | Cut‐off outcome | Main Results | Adjusted Variables |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Ayyub et al., (2018) | Pakistan | Cross‐sectional | 18 to 45 | 1st, 2nd and 3rd Trimester | 367 | Household food insecurity | Household food insecurity access scale (HFIAS) | NR | Depression | Edinburgh Postnatal Depression Scale (EPDS) | Cut‐off score depression ≥12 | Food insecurity increases the odds of antenatal depression (OR 2.96; 95% CI 1.920–4.570; AOR 2.58; 95% CI 1.641–4.075) | Adjusted for unwanted pregnancy |
| Dias et al., (2011) | Brazil | Cross‐sectional | 25.1 (6.7) | 1st, 2nd and 3rd Trimester | 94 | Household food insecurity | Brazilian Food Insecurity Scale (EBIA) | NR | Anxiety and depression |
Hamilton Anxiety Scale: HAMA Beck Depression Inventory: (BDI) |
NR Cut‐off score depression ≥10 |
Food insecurity variable (overall score) related to HAMA (p = 0.00; r = 0.508) and BDI (p = 0.00; r = 0.445) | NR |
| Dibaba et al., (2013) | Ethiopia | Cross‐sectional | 15 to >35 | 2nd and 3rd Trimester | 627 | Household food insecurity | Household food insecurity was measured with a six‐item scale based on previously validated measures in developing countries. | Two or more of the six household food security questions. | Depression | Edinburgh Postnatal Depression Scale (EPDS) | Cut‐off score depression ≥13 |
Food insecurity x Depressed mood (OR: 6.79; 95% CI: 4.31–10.72)* (AOR: 4.60; 95% CI: 2.75–7.70)* *p < 0.001 |
Adjusted for education, wealth tertile, occupation, perceived work burden, food security status, history of miscarriage of still birth and partner physical violence during pregnancy |
| Doglikuu et al., (2023) | Ghana | Cross‐sectional | 10 to 20 | NR | 225 | Household food insecurity | Household Food Insecurity Access Scale (HFIAS) | NR | Depression | Revised Children's Anxiety and Depression Scale (RCADS‐25) | NR |
High food Insecurity x High Depression (OR: 0.43; 95% CI: 0.17–1.11; p 0.082 AOR: 0.27; 95% CI: 0.11–0.71 p 0.008) |
Adjusted for education level, and parental occupation |
| Eick et al., (2020) | USA | Prospective cohort | 32 (5.4) | 2nd Trimester | 510 | Household food insecurity | Questionnaires designed psychosocial stress, work‐related stress, and the physical environment. | NR | Depression | Center for Epidemiologic Studies‐Depression (CES‐D) | NR | Strong correlation between food insecurity x depression (point biserial r = 0,65) | NR |
| Grilo et al., (2015) | USA | Cross‐sectional | 18.6 (1.7) | 2nd and 3rd Trimester | 881 | Household food insecurity | Questionnaire developed by the State of California Health and Human Services Agency, WIC Supplemental Nutrition Branch. | If participants answered 'no' during both the second and third trimesters of pregnancy, they were considered Food Secure. If they answered 'yes' at one time point, they were considered Acute Food Insecure and if they answered 'yes' at both time points, they were considered Chronic Food Insecure. | Anxiety and depression |
Generalised Anxiety Disorder Scale (GAD‐7) Center for Epidemiologic Studies‐Depression (CES‐D) |
NR Cut‐off score depression ≥16 |
Path Model Acute Food Insecurity x depressive symptoms 1.21 (0.55)* Acute Food Insecurity x anxiety 1.27 (0.56)* Chorinic Food Insecurity x Depressive Symptoms 4.01 (0.69)** Chorinic Food Insecurity x Anxiety 1.73 (0.52)** **p ≤ 0.001, *p ≤ 05 |
Analysis controlled for the effects of intervention, pre‐pregnancy BMI, mother's age, born outside the US, financial support, living situation, housing insecurity, smoking during pregnancy, and drinking during pregnancy on all mediators and birth outcomes. |
| Gross et al., (2018) | USA | Prospective cohort | >18 years | 2nd and 3rd Trimester | 410 | Household food insecurity | Food Security Module from the United States Department of Agriculture | Women were classified as food secure if they reported 2 or less food insecure conditions and food insecure if they reported 3 or more. | Depression | Patient Health Questionnaire (PHQ‐9) | Cut‐off score depression ≥5 | Food insecurity increases the odds of prenatal depressive symptoms (OR: 2.96; 95% CI: 1.91–4.59) | NR |
| Harrison et al., (2008) | USA | Cross‐sectional | 17 to >30 | NR | 1386 | Household food insecurity | Food Security Scale of the U.S. | Each of the 4 items retained is scored 0–2. A total of 6–8 points is scored as High Risk; a score of 3–5 is scored as Moderate Risk. | Depression | Patient Health Questionnaire (PHQ‐9) | Cut‐off score depression ≥10 | Food Insecurity is correlated to depression (Pearson correlation coefficient = 0.267*, *p < 0.0001) | NR |
| van Heyningen et al., (2017) | South Africa | Cross‐sectional | mean age 27 years; SD 5.8 | 1st, 2nd and 3rd Trimester | 376 | Household food insecurity | US Household Food Security Survey Module (HFSSM) | NR | Anxiety | Mini‐International Neuropsychiatric Interview (MINI Plus) | NR |
Meets criteria for food insecurity x diagnosis with any anxiety disorder (OR 2.49 CI 95% 1.52–4.08 p ≤ 0.001) Meets criteria for food insufficiency x diagnosis with any anxiety disorder (OR 2.91 CI 95% 1.56–5.43 p 0.001) |
NR |
| Khoshgoo et al., (2020) | Iran | Cross‐sectional | 28.59 ± 7.28 | 1st, 2nd and 3rd Trimester | 394 | Household food insecurity | Persian version of the Household Food Security Survey Module (HFSSM) |
Households without children under 18 years (total score: 10 points) Food secure (0–2) Food insecure without hunger (3–5) Food insecure with moderate hunger (6–8) Food insecure with severe hunger (9–10) Households with children under 18 years (total score: 18 points) Food secure (0–2) Food insecure without hunger (3–7) Food insecure with moderate hunger (8–12) Food insecure with severe hunger (13–18) |
Depression | Persian version of the Beck Depressive Inventory‐II (BDI‐II) questionnaire | Cut‐off score depression ≥14 | Household food insecurity increases the odds of antenatal depression (OR 4.08; 95% CI 2.65–6.30; p < 0.05; AOR 3.31; 95% CI 2.07–5.29; p < 0.05) | NR |
| Laraia et al., (2006) | USA | Cross‐sectional | 27.2 ± 5.6 | Before 20 wk gestation | 606 | Anxiety and Depression |
Spielberger's Trait Anxiety Inventory Center for Epidemiologic Studies Depression (CES‐D) |
NR Cut off score ≥30 |
Household food insecurity | USDA food security module | It was defined a household as 'marginally food secure' if 1 or 2 questions were answered in the affirmative. It was defined a household as food insecure (with or without hunger) if ≥3 questions were answered in the affirmative. |
Trait anxiety score increases the odds of Food insecurity (AOR 2.14; 95% CI 1.55–2.96) Depression symptoms score increases the odds of food insecurity (AOR 1.87; 95% CI 1.40–2.51) |
Adjusted for income, race, education, marital status, age and number of children |
| Laraia et al., (2022) | USA | Cross‐sectional | 15 to >35 | NR | 14274 | Household food insecurity | Security scale developed by the United States Department of Agriculture | More than one affirmative response indicated food insecurity, further defined as low food security (2–4 affirmative responses) or very low food security (5–6 affirmative responses) | Depression | NR | NR | OR 2.784; 95% CI 2.574–3.012 | NR |
| Mak (2019) | Canada | Cross‐sectional | 18 to 49 | NR | 4817 | Household food insecurity | U.S. Household Food Security Survey Module (HFSSM) |
Food‐secure: No items affirmed Marginally food‐insecure: 1 item affirmed Moderate‐severely food‐insecure: 2–10 items affirmed |
Diagnosis of anxiety disorder Diagnosed mood disorder (depression, bipolar disorder, mania or dysthymia) |
Interview in which the interviewee should report disorders if they were diagnosed by a health professional and lasted or is expected to last for 6‐months or longer. | NR |
Diagnosed anxiety disorder and Mod‐Sev Food Insecure: (AOR 3.2; 95% CI 1.92–5.43; p <0.001 Diagnosed mood disorder and Mod‐Sev Food Insecure: AOR 4.82; 95% CI 2.80–8.28; p < 0.001 |
Adjusted for household income, age, postsecondary education, indigeneity, 2‐year cycle |
| Matlwa et al., (2021) | South Africa | Cross‐sectional | NR | NR | 584 | Maternal hunger | Telephonic survey provided more detail on hunger. | At least 1 day reported going to bed hungry | Depression | Patient Health Questionnaire ‐9 (PHQ‐9) | Cut‐off score depression ≥10 | Respondents who reported they had gone to bed hungry at least once in the seven nights preceding the survey were twice as likely (OR 2.17; 95% CI 1.51–3.13; p < 0.05) to report high symptomatology on the Phq‐9 (score ≥10) | NR |
| Oladeji et al., (2022) | Nigeria | Cross‐sectional | 14 to 20 | Gestational age (mean [sd]): 23.78 (5.36) | 1359 | Household food insecurity | Food insecurity was defined as the number of days the respondent had gone to bed hungry in the previous 7 days because there was no food to eat. The type of instrument used was not reported. | At least 1 day reported going to bed hungry | Depression | Edinburg Postnatal Depression (EPDS) | Cut‐off score depression ≥12 |
A day or more gone bed with hungry x depression OR (95% CI) 2.82 (1.96, 4.05), p < 0.001 |
NR |
| Pobee et al., (2022) | Gana | Prospective cohort | 27.1 ± 5.2 years | 1st, 2nd and 3rd Trimester | 116 | Household food insecurity | US Household Food Security Survey Module | NR | Anxiety and depression |
Beck Anxiety Inventory (BAI) Center for Epidemiologic Studies‐Depression (CES‐D) |
Cut‐off score anxiety ≥14 Cut‐off score depression ≥10 |
Generalised Estimating Equation (GEE) model Depressive symptoms x Food insecurity: 0.594 (0.428, 0.761), p < 0.001 Total Anxiety symptoms x Food insecurity: 0.619 (0.389, 0.849), p < 0.001 |
NR |
| Sidebottom et al., (2014) | USA | Prospective cohort | <25 and > 25 | NR | 87 | Household food insecurity | Food Security Scale of the U.S. | It was created a summary score and classified a score between 0 and 2 as low risk and between 3 and 8 points as moderate/high risk. | Depression | Patient Health Questionnaire (PHQ‐9) | Cut‐off score depression ≥10 |
Food insecurity Moderate/high x depressive symptom levels (OR 2.44; 95% CI 1.43, 4.16, p 0.001) |
NR |
| Tsai et al., (2016) | South Africa | Prospective cohort | NR | NR | 769 | Food insufficiency | Food insufficiency was measured using a single‐item question, 'How many days in the past week have you gone hungry?' | At least 1 day reported hungry | Depression | Xhosa version of Edinburgh Postnatal Depression Scale (EPDS) | Cut‐off score depression ≥13 |
Hungry days and EPDS case: AOR 1.74; z 3.31; p > z 0.001; 95% CI 1.25–2.43 |
NR |
Abbreviations: AOR, Adjusted Odds Ratio; OR, Crude Odds Ratio; NR, Not reported.