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  • Print publication year: 2010
  • Online publication date: February 2010

Chapter 12 - Teenage pregnancies

from Section 3 - Specialized requirements


Poor fetal growth in the developing world is largely attributed to widespread maternal undernutrition. The majority of low birth weight (LBW) in developing countries is due to intrauterine growth restriction (IUGR), the causes of which are complex and multiple, depending primarily on the mother, placenta, fetus, and combinations of all three. The recent hypothesis on fetal origins of adult diseases suggests that fetal undernutrition at critical periods of development in utero and during infancy leads to permanent changes in body structure and metabolism. Cultural beliefs, practices, and food taboos play a role to some extent in determining maternal intakes in some of the populations in developing countries. In most populations, maternal diets are inadequate in both macronutrients and micronutrients. Minerals such as iron, zinc, and calcium are known to have an important role in fetal growth. Reappraisal of maternal interventions is essential to explore future possibilities through systematic research.


1. Office for National Statistics, Conceptions in England and Wales 2003. Health Stat Q (2005), 26:58–61
2. LawlorDA and ShawM, Teenage pregnancy rates: high compared with where and when. R Soc Med (2004), 97:121–3.
3. WellingsK and KaneR, Trends in teenage pregnancy in England and Wales: how can we explain them?J R Soc Med (1999), 92:277–82.
4. WhincupPH, GilgJA, OdokiK, TaylorSJC, and CookDC, Age of menarche in contemporary Britain teenagers: survey of girls born between 1982–1986. BMJ (2001), 322:1095–6.
5. KirbyD, Emerging Answers; Research Findings on Programs to Reduce Teen Pregnancy (Washington, DC: National Campaign to Prevent Teen Pregnancy, 2001).
6. HamiltonBE, MartinJA, and VenturaSJ, Births preliminary data for 2005. Natl Vit Stat Rep (2006), 55:11.
7. GiganteDP, RasmussenKM, and CesarGV, Pregnancy increases BMI in adolescents of a population based birth cohort. J Nutr (2005), 135:74–80.
8. KleinJD and the Committee on Adolescence, Adolescent pregnancy: current trends and issues. Paediatrics (2005), 116:281–6.
9. OumachiguiA, Pre-pregnancy and pregnancy nutrition and its impact on women's health. Nutr Rev (2002), 60:S64–7.
10. KumarA, SinghT, BasuS, PandeyS, and BhargavaV, Outcome of teenage pregnancy. Ind J Paed (2007), 74:927–31.
11. AndersonAS, MacintyreS, and WestP, Dietary patterns among adolescents in the West of Scotland. Br J Nutr (1994), 71:111–22.
12. SweetingH & WestP, Female and stressed: changing patterns of psychological distress over time. J Child Psychol Psychiatry (2003), 44:399–411.
13. GregoryJ, LoweS, BatesCJ, PrenticA, and JacksonLV, National diet and nutrition Survey: young people aged 4 to 18 years (London: The Stationery Office, 2000).
14. Department of Health (U.K.), Report on Health and Social Subjects 41. Dietary Reference Values for food energy and nutrients for the United Kingdom (Lodnon: HMSO, 1991).
15. InselP, TurnerRE, and RossD, Nutrition, 2nd edn (Subury, MA: Jones and Bartlett, 2004).
16. Australian Government Ministry, of Health, Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes (2006).
17. SchollTO, HedigerML, SchallJI, MeadJP, and FischerRL, Maternal growth during adolescent pregnancy. JAMA (1995), 274:26–7.
18. HowieLD, ParkerJD, and SchoendorfKC, Excessive weight gain patterns in adolescents. J Am Diet Assoc (2003), 103:1653–7.
19. SchollTO, HedigerML, and AncesIG, Maternal growth during pregnancy and decreased infant birth weight. Am J Clin Nutr (1990), 51:790–3.
20. SchollTO, HedigerML, AncesIG, BelskyDH, and SalmonRW, Weight gain during pregnancy in adolescence: predictive ability of early weight gain. Obstet Gynecol (1990), 75:948–53.
21. NielsenJN, GittelsohnJ Anliker J, and O'BrienK, Interventions to improve diet and weight gain among pregnant adolescents and recommendations for future research. J Am Diet Assoc (2006), 106:1825–40.
22. KingJC, The risk of maternal nutritional depletion and poor outcomes increases in early or closely spaced pregnancies. J Nutr (2003), 133:1732S–6.
23. Institute of Medicine, Nutrition during Pregnancy Part 1: Weight Gain (Washington, DC: National Academies Press, 1990).
24. GutierrezY and KingJC, Nutrition during teenage pregnancy. Pediatr Ann (1993), 22:99–108.
25. GrothSG, Are the Institute of Medicine recommendations for gestational weight gain appropriate for adolescents?J Obstet Gynecol Neonatal Nurs (2007), 36:21–7.
26. SukalichS, MingioneMJ, and GlantzJC, Obstetric outcomes in overweight and obese adolescents. Am J Ob Gyn (2006), 195:851–5.
27. Galtier-DereureF, BoegnerC, and BringerJ, Obesity and pregnancy: complications and cost. Am J Clin Nutr (2000), 71:1242S–8S.
28. SchollTO, HedigerML, KhooCS, HealeyMF, and RawsonNL, Maternal weight gain, diet and infant birth weight: correlations during adolescent pregnancy. J Clin Epidemiol (1991), 44:423–8.
29. SchollTO and ReillyT, Anemia, iron and pregnancy outcome. J Nutr (2000), 130:443S–7S.
30. MaiaPA, FigueiredoRCB, AnastacioAS, Da SilvieraCLP, and DonageloCM, et al. Zinc and copper metabolism in pregnancy and lactation of adolescent women. Nutrition 2007, 23:248–53.
31. National Institute for Health and Clinical Excellence, (2007) Guidance for midwives, health visitors, pharmacists and other primary care services to improve the nutrition of pregnant and breastfeeding mothers and children in low income households Programme Guidance Development. Available at:
32. AndersonAS, Pregnancy as a time for dietary change. Proc Nutr Soc (2001), 60:497–504.
33. CallinsKR, Sizing up our teens. Am J Obstetr Gynecol (2007), 196:6e7.
34. HuntDJ, StoeckerBJ, HermannJR, KopelBL, WilliamsGS, and ClaypoolPL, Effects of nutrition education programs on anthropometric measurements and pregnancy outcomes of adolescents. J Am Diet Assoc (2002), 102:S100–2.
35. HoelscherA, EvansA, ParcelGS, and KelderSH, Designing effective nutrition interventions for adolescents. J Am Diet Assoc (2002), 102(Suppl 3):S52–S63.
36. AndersonAS, Nutrition interventions in low income women. Proc Nutr Soc (2007), 66:25–32
37. OlsenSF, HalldorssonT, WalterWC, and NUTRIX Consortium, Milk consumption during pregnancy is associated with increased infant size at birth: prospective cohort study. Am J Clin Nutr (2007), 86:1104–10.
38. FoxMK, HamilitonW, and LinBH, Effects of Food Assistance and Nutrition Programs on Nutrition and Health: Volume 3, Literature Review. Food and Rural Economic Development, Economic Research Service, U.S. Department of Agriculture (2004). Available at:
39. U.S. Department of Agriculture, Economic Research Service, Informing Food and Nutrition Assistance Policy, 10 Years of Research at ERS MP-1598 (2007). Available at:
40. Expanded Food and Nutrition Education Program, FY 2001, Program Impacts (2001). Available at:,htm.
41. BoweringJ, MorrisonMA, LowenburgRL, and TiradoN, Role of EFNEP (Expanded Food and Nutrition Education Program) aides in improving diets of pregnant women. J Nutr Educ (1976), 8:111–17.
42. ArnoldCG and SobalJ, Food practices and nutrition knowledge after graduation from the Expanded Food and Nutrition Education Program (EFNEP). J Nutr Educ (2000), 32:130–8.
43. NielsonJ, O'BrienK, WitterFR, ChangSC, ManciniJ, NathansonMS, et al., (2006) High gestational weight gain does not improve birth weight in a cohort of African American adolescents. Am J Clin Nutr 84:183–9.
44. AndersonAS, CampbellD, and ShepherdR, Influence of dietary advice on nutrient intake during pregnancy. Br J Nutr (1995), 73:163–77.
45. DoyleW, WynnAHA, CrawfordMA, and WynSW, Nutritional counselling and supplementation in the second and third trimester of pregnancy, a study in a London population. J Nutr Med (1992), 3:249–256.
46. WriedenWL and SymonA, The development and pilot evaluation of a nutrition education intervention program for pregnant teenage women (food for life). J Hum Nutr Diet (2003), 16:67–71.
47. Department of Health, Healthy Start (2008). Available at:
48. BurchettH and SeeleyA, Good Enough to Eat? The Diets of Pregnant Teenagers (London: The Maternity Alliance and the Food Commission, 2003). Available at:
49. AndersonAS, Nutrition and pregnancy – motivations and interests. J Hum Nutr Diet (2003), 16:65–6.