|Butte, Nancy -|
Submitted to: Book Chapter
Publication Type: Book / Chapter
Publication Acceptance Date: June 1, 2008
Publication Date: January 1, 2009
Citation: Butte, N. 2009. Nutrition during pregnancy. In: Kleinman, R.E., editor. Pediatric Nutrition Handbook. 6th edition. United States of America: American Academy of Pediatrics. p. 249-273. Technical Abstract: The optimal nutritional support of a mother and her developing fetus begins before conception. This poses a challenge for pediatricians caring for pregnant adolescents. Approximately 1 million teenagers become pregnant in the United States each year. Of these pregnancies, 51% end in live births, 35% end in induced abortion, and 14% result in a miscarriage or stillbirth. Although birth rates to adolescents decreased in the 1990s, the teenage birth rate in 1996 (54.7 live births/1000) was still higher than the rate in 1980. The pregnant adolescent is more likely to be a member of a poor or low-income family (83%), to be unmarried (72%), and to have an unplanned pregnancy (>90%). One third of adolescents who become parents - mothers as well as fathers - were themselves the product of an adolescent pregnancy. Adolescent pregnancy is associated with an increased risk of medical complications, such as low birth weight, neonatal death, maternal mortality, pregnancy-induced hypertension, and sexually transmitted infections; the youngest adolescents appear to be at greatest risk. A low prepregnancy body mass index (BMI), low gestational weight gain, anemia, and a poor-quality diet are related to poor pregnancy outcomes among adolescents. Early prenatal care, including assessment of nutritional status, is of paramount importance for pregnant adolescents. Assessment of nutritional status should identify individuals who are significantly underweight or overweight as well as those with conditions such as bulimia, anorexia, pica, hypovitaminosis, or hypervitaminosis and special dietary habits, such as vegetarianism.