A review of the epidemiology of nutrition and adolescent pregnancy: Maternal growth during pregnancy and its effect on the fetus

University of Medicine and Dentistry of New Jersey, Department of Obstetrics and Gynecology, Camden 08103.
Journal of the American College of Nutrition (Impact Factor: 1.45). 05/1993; 12(2):101-7. DOI: 10.1080/07315724.1993.10718289
Source: PubMed


Maternal growth during adolescent pregnancy and its effects on pregnancy outcome have been a source of controversy. Maternal growth during pregnancy has been difficult to quantify because of the tendency of young and older women to "shrink" in stature with pregnancy. In the Camden Study, maternal growth during pregnancy was monitored with the Knee Height Measuring Device, which measures growth of the lower leg, a body segment less susceptible to "shrinkage." Attempts of other investigators to detect maternal growth during adolescent pregnancy are reviewed here. New data from the Camden Study, also presented, suggest that growing adolescents have infants that weigh less compared to nongrowing adolescents and mature controls (aged 19-29 years). Prior work had suggested that the effects of maternal growth on birth weight were confined to adolescent multiparas. However, with expanded enrollment it was found that infants of growing primiparas and multiparas were both affected. The hypothesis of the competition for nutrients between a still-growing gravida and her fetus is discussed.

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    • "Approximately 50% of adult weight and 15% of adult height is attained during adolescence (Rogal et al. 2000, Spear 2000). Due to chronic malnutrition in developing countries, age at menarche is delayed by about 3 years and growth continues until age 20 (Scholl et al. 1993, Riley et al. 1989). A World Health Organization analysis found that women with a pre-pregnancy weight of less than 45 kg and height of less than 145 cm were at increased risk of low birth weight and premature delivery (WHO 1995). "
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    ABSTRACT: The purpose of this study was to examine whether changes in the mid-upper arm circumference (MUAC) in pregnancy and early post-partum varied by maternal age. The MUAC of 3359 nulliparous pregnant women ≤25 years of age in rural Nepal was measured in early pregnancy and at 3 months post-delivery of a live-born infant. Regression was used to model the change in MUAC and prevalence of MUAC < 20 cm by maternal age, adjusted for confounders. A total of 5.2% of the pregnant women were under 16 years of age. The prevalence of MUAC measurements <20 cm was 11.3% in early pregnancy and did not differ by maternal age. The prevalence of low MUAC was 17.7% at post-partum, but those <16 years of age had a significantly higher prevalence of low post-partum MUAC [odds ratio: 2.47, 95% confidence interval (CI) 1.49, 4.10] compared with women 20-25 years of age, adjusted for maternal literacy, caste, meat consumption in early pregnancy and timing of measurements. All women reduced their MUAC from early pregnancy through post-partum. The adjusted loss of the MUAC among those under 16 years of age was 0.97 cm (95% CI: -1.33, -0.60), compared with 0.40 cm (95% CI: -0.70, -0.10) among women 20-25 years of age. In an energy-restricted environment, girls under 16 years contributed to a half centimetre more loss of MUAC than older women of the same parity. Such a loss of fat, muscle or both may put younger women and their breastfed offspring at greater risk of other adverse health and nutritional outcomes.
    Maternal and Child Nutrition 07/2010; 6(3):287-95. DOI:10.1111/j.1740-8709.2009.00211.x · 3.06 Impact Factor
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    • "In line with life history theory, the research conducted on the women of rural Gambia has found that younger age at first reproduction may be associated with shorter adult height (Allal, Sear, Prentice, & Mace, 2004; Sear, Allal, Mace, & McGregor, 2004). Furthermore, previous studies in epidemiology provide evidence that shorter adult height may also be related to earlier age at menarche (Georgiadis, 1997; Gigante, Horta, Lima, Barros, & Victora, 2006; Nettle, 2002; Okasha, McCarron, McEwen, & Smith, 2001; Onland-Moret et al., 2005) and that pregnancy in adolescent still-growing girls may impair their height gain (Gigante, Rasmussen, & Victora, 2005; Scholl & Hediger, 1993). In sum, the available data show associations compatible with the reproduction growth tradeoff in women. "
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    ABSTRACT: Women have been suggested to trade growth in height for reproduction, as an earlier age at menarche and first birth seem to be related to shorter adult stature. Although women likely accrue fitness benefits by maturing and starting reproduction at young age, short adult stature may be selected against by natural and sexual selection later in their life. We studied how age at menarche and first reproduction affected adult height and whether adult height in turn was related to lifetime reproductive success in Finnish women born 1946–1958. Our results show that a delay of 1 year in age at menarche and first reproduction was related to a 0.43-and 0.20-cm increase in adult height, respectively. The sex of the first-born offspring was not related to adult height. Moreover, women gained fitness benefits by starting reproduction early but not by growing tall. These findings among Finnish women are thus compatible with tradeoffs between reproduction and growth, by showing a compromised adult height at the cost of early age at menarche and first birth. However, in these women, natural selection favored those women who traded their stature for young motherhood.
    Evolution and Human Behavior 05/2008; 29(3). DOI:10.1016/j.evolhumbehav.2007.11.009 · 3.13 Impact Factor
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    • "This is similar to a Swedish study in which the risk of LBW or SGA for adolescents aged ≤17 years or 18−19 years was no greater than for women aged 20−24 years (Olausson et al. 1997). It does, however, contrast with the observations of a number of other studies that found a 25−60% increased risk of LBW or SGA for adolescents (Frisancho et al. 1985; Scholl & Hediger 1993; Fraser et al. 1995; Lee et al. 1998; Conde-Agudelo et al. 2005). In Camden, growing adolescents (age 12−19 years) delivered infants who were an average of 153 g lighter than adolescents who had completed their growth, and 93 g less than mature women aged 18 −29 years, after controlling for confounders (Scholl & Hediger 1993). "
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    ABSTRACT: Pregnancy during adolescence is associated with adverse birth outcomes, including preterm delivery and low birthweight. The nutrient availability to the fetus may be limited if the mother is still growing. This research aims to study the effects of pregnancy during adolescence in a nutritionally poor environment in rural Nepal. This study utilized data from a randomized controlled trial of micronutrient supplementation during pregnancy in south-eastern Nepal. Women of parity 0 or 1 and of age <or= 25 years who gave birth to a singleton liveborn infant who was measured within 72 h of delivery were included (n = 1393). There was no difference in the risk of low birthweight (OR = 0.96; 95% CI = 0.90-1.02) or small for gestational age (OR = 1.01; 95% CI = 0.94-1.08) per year of increasing maternal age among primiparae. Young maternal age did not affect the anthropometry or gestational age of the offspring of parity 1 women. Each year of increasing maternal age among primiparae was associated with increases in birth length (0.07 cm; 95% CI = -0.01 to 0.16), head (0.05 cm; 95% CI = 0.01-0.09) and chest circumference (0.07 cm; 95% CI = 0.01-0.12), but not weight (9.0 g; 95% CI = -2.1 to 21.8) of their offspring. Young maternal age was associated with an increased risk of preterm delivery among primiparae (OR = 2.07; 95% CI = 1.26-3.38) that occurred at an age cut-off of <or=18 years relative to those 19-25 years. Thus, we conclude that young maternal age (<or=18 years) increased the risk of preterm delivery, but not intrauterine growth retardation, for the first but not second liveborn infant.
    Maternal and Child Nutrition 07/2007; 3(3):174-85. DOI:10.1111/j.1740-8709.2007.00097.x · 3.06 Impact Factor
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