INADEQUATE WEIGHT-GAIN AMONG PREGNANT ADOLESCENTS - RISK-FACTORS AND RELATIONSHIP TO INFANT BIRTH-WEIGHT

OBJECTIVE: Our purpose was to identify behavioral markers for inadequa te weight gain (<20 pounds) during pregnancy among adolescents <18 yea rs old. STUDY DESIGN: A total of 337 adolescents who were delivered of a term infant at our institution between March 10, 1992, and November 28, 1994 participated in this study. A comprehensive structured inter view conducted at the first prenatal visit elicited demographic inform ation and behavioral risk factors. Maternal weights, reproductive hist ory, evidence of sexually transmitted disease, and infant birth weight were extracted from medical records. Logistic regression and chi(2) a nalyses compared characteristics and infant birth weights between thos e who gained <20 pounds with those who gained greater than or equal to 20 pounds. RESULTS: A total of 11.6% (39/337) of the total sample gai ned <20 pounds during the pregnancy. Adolescents who gained <20 pounds compared with greater than or equal to 20 pounds were delivered of si gnificantly lighter (2942 gm vs 3392 gm) infants and were more likely to be delivered of infants weighing <2500 gm (13% vs <1%). Stepwise lo gistic regression revealed that adolescents who were battered (odds ra tio 5.3) or had a sexually transmitted disease (odds ratio 2.3) or an unplanned pregnancy (odds ratio 8.1) were at increased risk for insuff icient weight gain during pregnancy. CONCLUSION: Our data suggest that behavioral risk factors are important in the identification of adoles cents at greatest risk for inadequate weight gain. Early identificatio n during pregnancy is essential to modify nutritional practices and th us minimize poor obstetric outcomes.