Adolescent pregnancy: Maternal weight effects on fetal heaviness: Possible route to improved outcomes

In a previous report of a zinc supplementation trial in pregnant adolescents zinc effect varied according to maternal weight (wt) status—normal (90–110% of expected wt), light or heavy, prompting this analysis of effects of wt status and gestational wt gain on fetal heaviness relative to length and gestational age (GA) and other pregnancy outcomes. One-third of adolescents shifted in or out of normal wt by delivery, creating seven outcome groups—light-light, light to normal, normal to light, normal-normal, normal to heavy, heavy to normal, and heavy-heavy. These wt class change groups varied significantly as to intrauterine growth (SGA, low AGA, high AGA, and LGA); by weekly grams gain per cm height (ht), birth wt, infant wt/length ratio, and occurrence of low birth wt (LBW). Infants with above average intrauterine growth had an advantage in: absolute size, length of hospital stay, rates of LBW, fetal demise, rates of low Apgar score, and other complications.This association between intrauterine growth and maternal wt class change suggests that promotion of wt gain might lower rates of LBW. Birthwt varied by quartiles of weekly wt change (gm) per cm ht in women grouped by their percent of expected wt: in the lowest quartile (Q₁) only one group in seven reached average Bwt (3025 grams); with Q₄ gain all groups did. Thus, the parameter wt gain/wk/cm ht deserves study as a tool for monitoring wt status and gain to identify those pregnant adolescents in greatest need for nutritional counseling and to set wt gain goals.Flora F. Cherry is Associate Professor of Maternal and Child Health (MCH), and Ehigie W. Ebomoyi is a post-doctoral research fellow in MCH in the Department of Applied Health Sciences; Patricio Rojas is Assistant Professor of Biostatistics; all at Tulane School of Public Health and Tropical Medicine, New Orleans, LA 70112.Harold H. Sandstead is Professor of Preventive Medicine and Community Health, University of Texas at Galveston.LuAnn K. Johnson is a biostatistician at the U.S. Department of Agriculture, Agricultural Research Service, Human Nutrition Research Center, Grand Forks, ND.Ananda R. Wickremasinghe is a fellow in the Population Genetics Program of Louisiana State University School of Medicine, New Orleans, LA.This study was funded by: (1) a U.S. Department of Agriculture, Sciences and Education Administration, Human Nutrition Extramural Research Grant to the Tulane University Medical Center; (2) a cooperative agreement (7USC, 427, 250A, 1624, 2201) between the US Department of Agriculture, Agricultural Research Services, Human Nutrition Research Center, Grand Forks, ND and Tulane Medical Center, New Orleans, LA; (3) Tulane University.