Relationship between maternal growth, infant birthweight and nutrient partitioning in teenage pregnancies

Objective Teenagers are susceptible to delivering small-for-gestational-age (SGA) infants. Previous studies suggest that maternal growth may contribute, as a result of preferential nutrient partitioning to the mother. We investigated the impact of maternal growth on birthweight in pregnant teenagers in the UK, and examined endocrine mediators of nutrient partitioning. Design A prospective observational multicentre study, About Teenage Eating, conducted between 2004 and 2007. Setting Four hospitals in socially-deprived areas of Manchester and London. Population A total of 500 pregnant adolescents (14-18 years of age) with a singleton pregnancy were recruited at 10-21 weeks of gestation, with follow-up studies on 368 subjects. A cohort of 80 pregnant adults (25-40 years of age) provided a control group for determining growth. Methods Skeletal growth, weight gain and skinfold thickness were measured from first to third trimester, together with maternal levels of micronutrients and metabolic hormones: insulin-like growth factor (IGF) system and leptin. Dietary analyses were performed. Main outcome measure SGA birth. Results Maternal growth was not associated with SGA birth: growing mothers delivered more large-for-gestational- age infants (OR 2.51; P <0.05). Growers had greater weight gain (P <0.001), fat accrual (P <0.001) and red cell folate concentrations (P <0.01) than non-growers. Maternal IGF-I (P <0.01) and leptin (P <0.001) were positively associated with maternal and fetal growth, whereas IGF-I (P <0.001) was negatively associated. Teenagers that were underweight at booking or with low weight gain were at greater risk of SGA birth. Conclusions Maternal growth was not detrimental to fetal growth in this UK population of teenagers. Greater weight gain and higher concentrations of IGF-I in growing teenagers may provide anabolic drive for maternal and fetal growth. © 2009 RCOG BJOG An International Journal of Obstetrics and Gynaecology.