Weight gain, nutrition, and pregnancy outcome: Findings from the camden study of teenage and minority gravidas

Abstract

Over the last 10 years researchers have been conducting studies of teenage and minority pregnant women in Camden New Jersey. They have learned the following information. Since maternal components account for about 70% of the total amount gained during the first two trimesters and fetal components account for about 50% of total amount gained at the end of pregnancy it may be more effective for providers to encourage weight gain early in pregnancy in young teenagers to enhance maternal stores. The median weight gain and rates of gain are higher in pregnant teens than pregnant adults throughout pregnancy (14-15 kg vs. 12.5 kg). The risk of poor pregnancy outcome increases with low or excessive weight gains. It can be detected late in the first or early in the second trimester. Reduced caloric intake is associated with inadequate maternal gestational weight gain because energy allows for effective use of available minerals protein and vitamins. Low intake of micronutrients is associated with an increased risk of poor pregnancy outcome (e.g. preterm delivery). Even if young growing pregnant teens gain ample weight and accumulate increased nutrient stores they do not appear to mobilize stores after 28 weeks gestation to enhance fetal growth reserving the stores instead for their own continued growth. Teens who gain excessive gestational weight (>0.68 kg/week) retain more weight at 4-6 weeks postpartum and have a higher postpartum body mass index (BMI) than those who have low or normal gestational weight gain. Thus excessive weight gain which is common among low-income teens may promote obesity and a centripetal fat pattern during the reproductive years. This suggests that providers should weigh the benefits of extending care to return women to a postpartum BMI in the normal range through diet and exercise against the long term costs associated with the sequelae of maternal overweight and obesity.