Implications of the Camden Study of Adolescent Pregnancy: Interactions Among Maternal Growth, Nutritional Status, and Body Composition

Abstract

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.

Multiple Micronutrient Supplementation during Pregnancy and Lactation in Low-to-Middle-Income Developing Country Settings: Impact on Pregnancy Outcomes

“…Since maternal malnutrition, micronutrient deficiencies and SGA births remain major determinants of stunting in early childhood, malnutrition prevention has undergone a paradigm shift from targeting pregnant women to an increased advocacy of targeting these deficiencies earlier in the life cycle through promoting adolescent health and nutrition, delaying first pregnancies and increased birth spacing. Adolescent nutrition is also important with regard to maternal nutrition as pregnant adolescents are at risk of adverse outcomes including LBW, preterm delivery, anemia and excessive postpartum weight retention due to a combination of physiological, socioeconomic and behavioral factors [84,85,86]. …”

Breastfeeding Pattern and Duration and Post-Partum Maternal Weight Retention

“…This study suggested a marginally constant effect of any BF duration on PPWR in overweight mothers but not in obese women, despite the continuity of BF until 12 months postpartum. Obesity produces physiological changes in body composition, reduction in insulin sensitivity, decreased intention to BF, decreased initiation of BF, and decreased duration of BF [30]. Less The higher percentage of children followed-up at ages 3 (95.7%) and 12 months (94.3%), the nature of data collection and the populationbased recruitment are the strengths of this birth cohort [13].…”

Prepregnancy body mass index and cardiovascular disease mortality: The child health and development studies

“…Given the skepticism around the results in older adults, we further explored this relationship in our dataset using sensitivity analyses. Since some evidence suggests that pregnant adolescents are more likely to become overweight or obese in adulthood(33, 34) and because the underweight category disproportionately included adolescents, we excluded them from the analysis. We also excluded smokers, who may be underweight but have higher mortality, and assessed whether women in the underweight group had more pre-pregnancy co-morbid illnesses, as being underweight could be marker for poor health status.…”