Maternal growth during pregnancy and the competition for nutrients.

Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine, Camden 08103.
American Journal of Clinical Nutrition (Impact Factor: 6.92). 09/1994; 60(2):183-8.
Source: PubMed

ABSTRACT The influence of maternal growth in knee height during pregnancy on birth weight, gestation, and maternal body composition was examined in 318 teenagers (144 growing, 174 nongrowing) and 276 mature women from the Camden Study. Body-composition differences associated with maternal growth did not arise until after 28 wk gestation, when growing gravidas continued to accrue fat, had larger gestational gains, and retained more of their gestational weight gain postpartum. Nevertheless, still-growing young mothers had infants with lower birth weight, particularly when the mother continued to accrue higher amounts of fat on the arm or back (subscapular site) late in gestation. Thus, despite an apparently sufficient weight gain and the accumulation of abundant stores during pregnancy, young still-growing women appeared not to mobilize fat reserves late in pregnancy to enhance fetal growth, apparently reserving them instead for their own continued development.

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    ABSTRACT: Background We examined the associations of maternal age with low birthweight (LBW) and preterm birth in four cohorts from a middle- and a high-income country, where the patterning of maternal age by socio-economic position (SEP) is likely to differ.Methods Population-based birth cohort studies were carried out in the city of Pelotas, Brazil in 1982, 1993, and 2004, and in Avon, UK in 1991 [Avon Longitudinal Study of Parents and Children (ALSPAC)]. Adjustment for multiple indicators of SEP were applied.ResultsLow SEP was associated with younger age at childbearing in all cohorts, but the magnitudes of these associations were stronger in ALSPAC. Inverse associations of SEP with LBW and preterm birth were observed in all cohorts. U-shaped associations were observed between maternal age and odds of LBW in all cohorts. After adjustment for SEP, increased odds of LBW for young mothers (<20 years) attenuated to the null but remained or increased for older mothers (≥35 years). Very young (<16 years) maternal age was also associated with both outcomes even after full SEP adjustment. SEP adjusted odds ratio of having a LBW infant in women <16 years and ≥35 years, compared with 25–29 years, were 1.48 [95% confidence interval (CI) 1.00, 2.20] and 1.66 [95% CI 1.36, 2.02], respectively. The corresponding results for preterm birth were 1.80 [95% CI 1.23, 2.64)] and 1.38 [95% CI 1.15, 1.67], respectively.Conclusion Confounding by SEP explains much of the excess risk of LBW and preterm among babies born to teenage mothers as a whole, but not for mothers aged <16 or ≥35 years. Given that the proportion of women becoming pregnant at <16 years is smaller than for those ≥35 years, the population burden is greater for older age.
    Paediatric and Perinatal Epidemiology 12/2014; 29(1). DOI:10.1111/ppe.12162 · 2.16 Impact Factor
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    ABSTRACT: A key target in the U.S. health policies is to reduce costly adverse birth outcomes to which prenatal smoking is one of the most significant contributors. This paper is the first to address whether implementing minimum cigarette purchase age of 21 at Pennsylvania can improve infant health through curbing smoking among young mothers. My research question is crucial because young mothers are heavily engaged in smoking and have more low birth weight babies, and smoking prevalence among mothers in Pennsylvania also exceeds the national average. The potential scope of this regulation is therefore large. I use a unique large dataset to find there is a 16 percent decrease in the average cigarettes smoked per day and a 20 percent decrease in low birth weight for mothers subject to the regulation at the cutoff. The 2SLS regression discontinuity estimates indicate that smoking 1 more cigarette per day during pregnancy worsens a variety of birth outcomes among all mothers. For smok-ers, it reduces birth weight by 61.17 grams, increases the probability of low birth weight by 2.8 percentage points, and decreases the APGAR 1 minute score by 0.13 points. The large intergenerational benefits induced by the law shed new light on the current political debate in many other states on whether enforcing MCPA 21.
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    Acta Tropica 12/2014; 144. DOI:10.1016/j.actatropica.2014.12.009 · 2.52 Impact Factor

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