Rate and amount of weight gain during adolescent pregnancy: associations with maternal weight-for-height and birth weight

Article Abstract:

Adolescents are more likely than adults to have poorer outcomes of pregnancy. Increased weight gain by adolescents is associated with improved infant birth weight. Larger weight gains than those recommended for adults may be appropriate for adolescents, because adolescents apparently transfer less of the gained weight to the fetus, possibly due to continued maternal growth. The timing and rate of weight gain are also important, as inadequate weight gain before the twenty-fourth week is associated with fetal growth retardation, even if the final maternal weight is within the target range. Poor later maternal weight gain is associated with a risk of premature delivery. However, the actual course of weight gain in pregnant adolescents is not well studied. The patterns of weight gain and infant birth weight in 1,419 adolescents with uncomplicated deliveries were evaluated. Both very early and total weight gains of adolescents were significantly greater than that reported for adults. However, this did not result in improved infant birth weight, which may reflect the tendency of some adolescents to retain excessive fluid, which would not benefit infant growth. Even when analyzed as weight at delivery per height, with 120 percent of the standard weight-for-height being considered desirable, birth weights did not compare with those from adult pregnancies until adolescents attained 140 percent of this ratio. Very young mothers, under 14 years old, had much larger weight gains during the second half of pregnancy, and this may be due to excessive fluid retention. Puerto Rican and black adolescents gained significantly less than whites, with Puerto Ricans gaining less from early in the first trimester, while weight gain of blacks slowed late in the second trimester. In adults, prepregnancy weight and pregnancy weight gain independently and additively improve birth weight, but for adolescents, these factors were beneficial independently but not additively. Further research is needed to establish the optimal weight gain in adolescents. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Maternal growth during pregnancy and decreased infant birth weight

Article Abstract:

Adolescents who are pregnant often have low-birth-weight infants. This poor outcome has been theorized to be due to competition for nutrition between the still-growing mother and the needs of the fetus. Previously, methods to detect growth in pregnant adolescents have not been satisfactory, due to postural alterations of spinal height, for example. Another confounding factor has been the known tendency of women to become slightly shorter while pregnant. A knee-height measuring device (KHMD) has been used to measure the growth of 166 12- to 15-year-old primigravidas (having first pregnancy) and 146 15- to 18-year-old multiparas (second or later pregnancy) who had their first pregnancy when they were 12 to 15 years old. Their heights and pregnancy outcomes were compared with those of 204 mature (at least age 18 at first pregnancy) primigravidas and multiparas. Both adolescent and mature gravidas (pregnant women) had a decrease in stature, but the average decrease in adolescents was significantly less than that of mature subjects, suggesting that the adolescents were growing. The adolescents were twice as likely as mature subjects to increase in height by over one-third of an inch, and the speed of growth was significantly greater in the group of adolescents. After accounting for confounding factors such as smoking and length of pregnancy, maternal growth was found to be significantly associated with decreased infant birth weight in adolescent multiparas, but not adolescent primigravidas. The lack of an effect in primigravidas may be due to their having adequate nutritional stores to support the first pregnancy. The results as a whole, however, support the theory that maternal growth during adolescence is associated with increased risk of low birth weight, and consequently, increased risk of infant illness and death. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors

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Weight gain during pregnancy in adolescence: predictive ability of early weight gain

Article Abstract:

The amount of weight gained by the mother during pregnancy is related to the size of the infant at birth. Abnormally high or low weight gains in pregnant adolescents can contribute to poor pregnancy outcomes, such as complications of labor and infant illness or death. The influence of high and low weight gain during adolescent pregnancy, and how weight gain relates to infant birth weight, were studied among 2,008 women under 18 years of age. Each mother's weight gain was examined every four weeks from the twelfth to the thirty-sixth week of pregnancy. Maternal weight gain was compared with reference range weight gains derived from uncomplicated full-term deliveries in adolescent mothers. There was an association between the amount weight the mother had gained by the twelfth week of pregnancy and the eventual birth weight of the baby. If the maternal weight gain fell below the twenty-fifth percentile at 16 weeks gestation, the fetus was 1.56 times more likely to be born with a low birth weight. Conversely, if the maternal weight gain fell above the seventy-fifth percentile at 16 weeks, the fetus was twice as likely to be excessively large; this is referred to as macrosomia. Inadequate or excessive maternal weight gain as early as the first three months of pregnancy increases the risk of complications in adolescent mothers and their babies. This indicates that it is important to monitor the mother's weight gain even early in pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Causes of, Pregnancy, Pregnancy, Complications of, Pregnancy complications

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