Obstetrical outcomes in overweight adolescents

Sukalich, Sara; Mingione, Matthew; Glantz, J. Christopher

doi:10.1016/j.ajog.2005.10.427

Cited by 2 publications

(3 citation statements)

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“…Though there is some consensus that the dietary intake of pregnant adolescents is often lower than recommended in terms of energy and a range of micronutrients [7], there is also evidence that pregnant adolescents, particularly those ,15 yr of age, are at risk of excessive gestational weight gain (.18 kg) [42], similar in magnitude to the weight change measured in the ON and rapidly growing adolescent dams studied here. Moreover, though there is some indication that older obese adolescents (average age 17 yr) are at increased risk of fetal macrosomia [43], average birth weight is significantly lower in still-growing mothers or in mothers who have not achieved their adult height at the time of conception [9,44,45]. Although some authors have suggested that improving diet and gestational weight gains may improve pregnancy outcome in the young adolescent population [8,46], the results of this highly controlled study in animals of the same age suggest that hugely increasing energy and protein intake per se is likely to be detrimental with respect to fetal growth in that the incidence of intrauterine growth restriction was markedly higher in the ON compared with the UN groups, irrespective of initial BMI.…”

Section: Discussionmentioning

confidence: 97%

Effect of Weight and Adiposity at Conception and Wide Variations in Gestational Dietary Intake on Pregnancy Outcome and Early Postnatal Performance in Young Adolescent Sheep1

Wallace

Milne

Aitken

2010

Biology of Reproduction

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Nutritional backgrounds prior to pregnancy may interact with subsequent gestational intake to influence pregnancy outcome, particularly in young, growing adolescents. To investigate this interaction, singleton pregnancies were established in two groups of adolescent sheep of identical age but different initial weight and adiposity score, classified as good (G) and poor (P) body mass index (BMI). Thereafter, ewes were offered either an optimal control (C) intake to maintain adiposity throughout pregnancy, undernourished (UN) to maintain weight at conception but deplete maternal body reserves, or overnourished (ON) to promote rapid maternal growth and adiposity, resulting in a 2 x 3 factorial design. Gestation length was independent of BMI and reduced in ON dams. Average placental and lamb birth weights were influenced by initial BMI (G > P) and gestational intake (C > UN > ON), with the highest incidence of growth restriction in ON groups. Metabolic challenges at two thirds of gestation revealed enhanced insulin insensitivity in ON dams (higher glucose postinsulin challenge and higher insulin postglucose challenge), but nevertheless fetal growth was constrained. Initial colostrum yield, total IgG, and nutrient supply were reduced in ON groups, but these low-birth-weight lambs exhibited rapid catch-up growth to weaning. Thus, both maternal BMI at conception and gestational intake have a profound influence on pregnancy outcome in young, putatively growing adolescent sheep and may have implications for the nutritional management of pregnant adolescent humans.

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Section: Discussionmentioning

confidence: 97%

Effect of Weight and Adiposity at Conception and Wide Variations in Gestational Dietary Intake on Pregnancy Outcome and Early Postnatal Performance in Young Adolescent Sheep1

Wallace

Milne

Aitken

2010

Biology of Reproduction

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“…Sukalich et al first reported on the increased risks of cesarean delivery and BMI of obesity in adolescents in a retrospective study of birth certificate data of predominantly Caucasian teenagers. 10 They excluded underweight women from their control group and found increasing risk of cesarean delivery with increasing BMI class and increasing weight gain. Multivariate analysis in their study showed that both BMI and weight gain were independent risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…A retrospective study of pregnant Caucasian adolescents focused specifically on maternal age less than 19 years and compared normal prepregnancy BMI with BMI greater than 25 through birth certificate records. 10 Underweight women were excluded from the analysis. Results indicated that the risk of cesarean delivery, induction, gestational hypertension, and macrosomia were all elevated in the higher BMI category.…”

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confidence: 99%

The Effects of Obesity and Weight Gain in Young Women on Obstetric Outcomes

Magriples¹,

Kershaw²,

Rising³

et al. 2008

Amer J Perinatol

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We investigated body mass index (BMI) and weight gain among pregnant women (ages 14 to 25) and assessed the relationship of BMI and weight gain on birth outcomes. We performed a secondary analysis of 841 women enrolled in a randomized controlled trial receiving prenatal care in two university-affiliated clinics. Almost half the patients were overweight or obese. An average of 32.3 ± 23.6 pounds was gained in pregnancy with only 25.3% gaining the recommended weight and over half overgaining. Weight gain had a significant relationship to birth weight. Multivariate analysis showed that prepregnancy BMI but not weight gain was a significant predictor of cesarean delivery (odds ratio [OR] 1.91, confidence interval [CI] 1.24 to 2.69, p < 0.0001). When large-for-gestational-age infants were removed from the analysis, there was still a significant effect of BMI on cesarean delivery (OR 1.76, CI 1.17 to 2.66, p = 0.007) but not of weight gain (OR 1.45, CI 0.94 to 2.17, p = 0.093). Prepregnancy BMI is a more significant predictor of cesarean delivery than pregnancy weight gain in young women.

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Obstetrical outcomes in overweight adolescents

Cited by 2 publications

References 0 publications

Effect of Weight and Adiposity at Conception and Wide Variations in Gestational Dietary Intake on Pregnancy Outcome and Early Postnatal Performance in Young Adolescent Sheep1

Effect of Weight and Adiposity at Conception and Wide Variations in Gestational Dietary Intake on Pregnancy Outcome and Early Postnatal Performance in Young Adolescent Sheep1

The Effects of Obesity and Weight Gain in Young Women on Obstetric Outcomes

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