Annals of the New York Academy of Sciences, Vol 817, Issue 1 281-291, Copyright © 1997 by New York Academy of Sciences
Implications of the Camden Study of adolescent pregnancy: interactions among maternal growth, nutritional status, and body composition
M. L. Hediger, T. O. Scholl and J. I. Schall
Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey-SOM, Stratford 08084, USA. hediger@umdnj.edu
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.
