Weight gain in adolescents during pregnancy: rate related to birth-weight outcome

Adolescents with adequate birth weight newborns diminish energy expenditure and cease growth

Maternal energy requirements increase during pregnancy but the magnitude of this increment is unknown among adolescents. We determined the effects of maternal age and weight status on adjustments in gestational weight gain, resting energy expenditure (REE), and growth among adolescents. Weight, and growth rates of pregnant adolescents (PA) < or =17 y during late pregnancy were compared with changes in nonpregnant adolescents (NPA) over a 5-mo period. REE was also measured monthly in the PA group. Paired t-tests and general linear models for repeated measures were used for the analysis; height was included as a confounding variable. Weight, height, and BMI of the PA and NPA women did not differ at baseline. During the follow-up period, NPA grew 0.94 +/- 30 cm; growth rate was greater in adolescents < or =14 y of age (P < 0.001) than in the older subjects. No growth occurred in the PA group. REE tended to increase linearly between 20 and 36 wk of gestation (P = 0.164); the net change in women >14 y (25%) tended (P = 0.164) to be greater than that of younger adolescents (7%). The mean increment of REE from wk 20 to wk 36 was 230 +/- 30 kcal/d (962 +/- 126 kJ/d) and the smallest increase occurred in women with BMI <20 (P = 0.010). Women with BMI <20 had a decrease in REE/kg that was greater than that of normal weight (BMI 20-25) or overweight (BMI > or =25) women (within subject, P = 0.010; between subject, P = 0.001). In conclusion, PA appear to adjust their resting energy needs by ceasing growth.

Adolescent girls and their babies: achieving optimal birthweight. Gestational weight gain and pregnancy outcome in terms of gestation at delivery and infant birth weight: a comparison between adolescents under 16 and adult women

AIMS

Pregnancy amongst under 16s has been reported to result in worse outcomes for the baby, including low birthweight. This study aimed to find out whether the under 16s need to gain more weight during pregnancy to avoid this outcome.

METHOD

A retrospective case control study of pregnancy outcomes in girls delivering before the age of 16 and women delivering aged 25-30. Data was collected from medical case notes, including maternal age, pregnancy weight gain and infant birth weight.

RESULTS

Although weight gain amongst under 16s was similar to that in the control group, average birthweight of babies born to under 16s was less than in the older group. For both girls and older women greater weight gain in pregnancy did result in higher birth weights.

DISCUSSION

As younger girls are still growing it may be necessary for them to achieve a greater pregnancy weight gain in order to achieve a satisfactory birth weight.

What's so bad about teenage pregnancy?

A systematic literature review identified the most frequently cited medical consequences of teenage pregnancy as anaemia, pregnancy-induced hypertension, low birth weight, prematurity, intra-uterine growth retardation and neonatal mortality. Critical appraisal suggested that increased risks of these outcomes were predominantly caused by the social, economic, and behavioural factors that predispose some young women to pregnancy. Maternal age less than 16 years was associated with a modest (1.2-2.7 fold) increase in prematurity, low birth weight and neonatal death.

Depression and body fat deposition in Mexican pregnant adolescents

BACKGROUND

The objective of this study was to assess the effect of maternal depressive symptomatology on fat deposition in a group of pregnant adolescents.

METHODS

A case-control study was performed with 85 pregnant women (45 adolescents and 40 adults) who attended a prenatal care course at a teaching hospital in Mexico City. During the second and third trimesters of gestation, a test proposed by Zung was applied to measure depressive symptoms. Weight and skinfolds (i.e., triceps, biceps, suprailiac, subscapular, and thigh) were measured in all women beginning at week 20 of gestation through 4 weeks postpartum. Monthly evaluations were performed.

RESULTS

At the 28th week of gestation, nearly 40% of pregnant adolescents showed scores above the cut-off points in the depression test, while among the adults this proportion corresponded to 15%. In the adolescents, depression status was related to self-esteem. Percentage of body fat in adult women tended to be relatively constant, while in adolescents a tendency toward increased body fat was found. In adolescents, depressive symptomatology and especially lack of self-esteem and weight gain during pregnancy were the variables that better predicted the fat-increment pattern during gestation, while in adults no variable was found that predicted fat deposition.

CONCLUSIONS

Depression status is a risk factor for excessive fat deposition during pregnancy in Mexican adolescents.

Implications of the Camden Study of adolescent pregnancy: interactions among maternal growth, nutritional status, and body composition

One of the principal goals of the Camden Study over the past decade has been to document the extent to which pregnancy during adolescence is affected by continued maternal growth. Findings from the Camden Study relating to the other main goal, the effects of maternal growth during pregnancy on the outcome of pregnancy (maternal-fetal competition), are reviewed elsewhere. Contrary to widely held beliefs, we have found that there is considerable growth in late adolescence for girls, and, in particular, continued development of weight (> 1 kg/year) and increases in subcutaneous fatness at central sites. Thus, when pregnancy occurs during this final phase of adolescent growth, the normal growth processes may be exacerbated. That is, the adolescent potential for weight gain (as fat) may be exploited. Along with others, we have documented that adolescent pregnancy is associated with larger gestational weight gains. Using methods sufficiently sensitive to detect maternal growth prospectively, we also found that the larger-than-average total weight gains among adolescents appear attributable primarily to the growing adolescent gravidas and reflect their continued accrual of subcutaneous fat and increased risk for weight retention. Excessive gestational weight gain, as is more common among growing adolescent gravidas, appears to exacerbate the accumulation of fat at central sites. Aside from the consequences to the outcome of pregnancy, adolescents who begin their childbearing early while still growing themselves, such as those we have followed in the Camden Study over the past decade, may be at particularly increased risk for overweight and obesity. Further, the excessive deposition of subcutaneous fat at central body sites, as we have documented for adolescent pregnancy, will often in later life presage the development of cardiovascular disease, noninsulin-dependent diabetes mellitus (NIDDM), and hypertension. Thus, far from being benign, pregnancy during adolescence, particularly when the adolescent is herself still growing, may contribute to long-term risk for obesity-related diseases and diminish the quality of life.