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.