Gestational weight gain and birth outcomes among pregnant African American adolescents in Baltimore City

Pregnant adolescents are at risk for adverse outcomes including low birth weight, preterm delivery, anemia and excessive post-partum weight retention, due to a combination of physiological, socioeconomic and behavioral factors. Among the most important modifiable contributors to healthy outcomes are appropriate nutritional intake and gestational weight gain.; We conducted a secondary data analysis using prenatal medical records of 1120 African American adolescents who attended the Maternity Center East clinic of the Johns Hopkins Hospital between 1990-2000 to improve understanding of the patterns of gestational weight gain associated with optimal birth weight in this sample. Examination of total gestational gain indicated that the majority of these teens gained within or above the upper half of the ranges recommended by the Institute of Medicine. The higher gains were not clearly beneficial, particularly among teens entering pregnancy overweight. We concluded that such teens may need support to avoid excessive gestational weight gain and related adverse health consequences. An investigation of the weekly rate of weight gain during gestation weeks 20-32 indicated it has low validity as a screening test for the risk of inadequate or excess total gestational weight gain at term in this sample, and thus should not be recommended as a tool for practitioners.; A review of the literature assessing prenatal nutrition interventions for pregnant adolescents revealed that the most common approach is comprehensive prenatal care supplemented with nutrition education or counseling. Many controlled studies suggest these programs contribute to improved gestational weight gain, birth weight and reduced incidence of low birth weight. Dietary quality and outcomes for mothers and infants might be further improved by behavior change strategies shaped by a theoretical framework, formative research, and attention to the individual, interpersonal, and environmental barriers to healthier food choices. The studies also provided evidence that prenatal care tailored to the special needs of adolescents improves pregnancy outcomes and is cost-effective. The findings suggest that the closure of the Maternity Center East clinic, which provided such specialized care along with subsidized family planning services, may impose costs on the East Baltimore community it served well for over 30 years.