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  • Title: Maternal growth during pregnancy and the competition for nutrients.
    Author: Scholl TO, Hediger ML, Schall JI, Khoo CS, Fischer RL.
    Journal: Am J Clin Nutr; 1994 Aug; 60(2):183-8. PubMed ID: 8030595.
    Abstract:
    The influence of maternal growth in knee height during pregnancy on birth weight, gestation, and maternal body composition was examined in 318 teenagers (144 growing, 174 nongrowing) and 276 mature women from the Camden Study. Body-composition differences associated with maternal growth did not arise until after 28 wk gestation, when growing gravidas continued to accrue fat, had larger gestational gains, and retained more of their gestational weight gain postpartum. Nevertheless, still-growing young mothers had infants with lower birth weight, particularly when the mother continued to accrue higher amounts of fat on the arm or back (subscapular site) late in gestation. Thus, despite an apparently sufficient weight gain and the accumulation of abundant stores during pregnancy, young still-growing women appeared not to mobilize fat reserves late in pregnancy to enhance fetal growth, apparently reserving them instead for their own continued development. The influence of maternal growth in knee height during pregnancy on birth weight, gestation, and maternal body composition was examined in 318 teenagers (144 growing, 174 nongrowing) and 276 mature women from the prospective study of nutrition and pregnancy in Camden, NJ, one of the poorest cities in the continental United States. Enrollments included parous and nulliparous teenagers younger than 19 years of age along with more mature parous and nulliparous control subjects (aged 19-29 years) delivering between July 1987 and January 1992. Measures of maternal body composition taken at entry to prenatal care and at 28 weeks of gestation indicated little difference according to maternal growth in knee height. By the beginning of the third trimester, all groups had similar amounts of subcutaneous body fat and muscle. After 28 weeks, growing gravidas failed to lose fat at the sub-scapular site and tended to accrue fat at the triceps site, whereas mature women and nongrowing teenagers lost fat from their upper arms and backs. The more extreme example of this change in body composition for arm-fat area ( 2.6 square cm in 42% of growers vs. 18% of nongrowing teenagers and 21% of mature women, p 0.001) or subscapular skinfold thickness ( 1.5 mm in 32% of growers vs. 25% of nongrowing teenagers and 22% of mature women, p= 0.07) also was more prevalent among growers. When energy intake was adequate but growth continued, infant birth weight was reduced (-86 g), but when intake was inadequate and the mother continued to grow, the birth weight deficit was quite large (-320 g). Ratios of maternal net weight gain and infant birth weight to total gestational gain suggested that, when the mother was still growing, she retained a larger proportion of the total gestational gain. In the growing gravidas, infant weight was a significantly smaller proportion of total gestational gain; conversely, net maternal gain (at delivery) was a significantly larger proportion.
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