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Maternal weight gain, diet and infant birth weight: correlations during adolescent pregnancy
T O Scholl1, M L Hediger, C S Khoo
1Department of Obstetrics and Gynecology, UMDNJ-SOM, Camden, NJ 08103-1505.
Insights
Inadequate pregnancy weight gain in teenagers is linked to lower birth weight. Dietary intake, particularly calories and protein, influences weight gain, which indirectly affects birth outcomes.
Area of Science:
- Maternal-fetal medicine
- Nutritional science
- Public health
Background:
- Inadequate weight gain during pregnancy is a significant risk factor for low birth weight (LBW).
- The specific contribution of maternal diet to pregnancy weight gain and subsequent birth outcomes remains unclear.
- Adolescent pregnancy presents unique nutritional challenges and increased risk for adverse outcomes.
Purpose of the Study:
- To examine the relationship between pregnancy weight gain patterns and birth weight in a cohort of young pregnant women.
- To investigate the association between dietary intake and pregnancy weight gain.
- To determine the direct and indirect effects of nutrient intake on birth weight, LBW, and preterm delivery.
Main Methods:
- Longitudinal study of over 2000 pregnant women aged ≤18 years.
- Weight gain assessed at 4-week intervals from 12 to 36 weeks' gestation.
- Dietary intake analyzed using 24-hour recalls in a 15% subsample.
Main Results:
- Early inadequate weight gain (by 16 weeks) was associated with a significant decrement in birth weight.
- Teenagers with inadequate total pregnancy weight gain consumed fewer calories, protein, and carbohydrates compared to those with adequate gain.
- No direct association was found between nutrient intake and birth weight, LBW, or preterm delivery, suggesting a mediating role for weight gain.
Conclusions:
- Pregnancy weight gain, influenced by dietary intake, is a critical mediator between nutrition and birth weight in adolescent mothers.
- Interventions promoting adequate caloric, protein, and carbohydrate intake may improve pregnancy weight gain and birth outcomes.
- Focusing on achieving adequate gestational weight gain is crucial for mitigating the risk of low birth weight in young women.
Abstract:
Inadequate weight gain during pregnancy is an important risk factor for low birth weight (LBW), but the contribution of diet to weight gain is uncertain. Pregnancy weight gains were examined at 4-week intervals from 12 to 36 weeks' gestation, as well as total gain for gestation, in a cohort of over 2000 young pregnant women, aged less than or equal to 18 at entry to prenatal care. The effect of diet was studied in a 15% random sample of the cohort, using a 24-hour dietary recall obtained at entry to prenatal care (averaging 17 weeks' gestation). As early as 16 weeks' gestation, gains below the lower limit of a clinical standard were associated with a decrement in birth weight at delivery of more than -85 g (p less than 0.01), and after 24 weeks of approximately -180 g (p less than 0.001). After adjusting for potential confounding variables, teenagers who went on to develop inadequate total weight gain for gestation had consumed 1878 kcal vs 2232 for teenagers with adequate total gain (p less than 0.05). There were significant deficits in protein (p less than 0.05) and carbohydrate intake (p less than 0.05) associated with inadequate gain. However, there was no direct effect of nutrient intake on birth weight, LBW, or preterm delivery. This suggests that the relationship between nutrient intake during pregnancy and birth weight may be indirect and moderated by weight gain during pregnancy.