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  • Title: Maternal growth during pregnancy and lactation.
    Author: Scholl TO, Hediger ML, Cronk CE, Schall JI.
    Journal: Horm Res; 1993; 39 Suppl 3():59-67. PubMed ID: 8262493.
    Abstract:
    Until recently, it was widely accepted that the small amount of statural growth observed in young gravidas was unlikely to be clinically significant, to alter maternal nutritional status, or to threaten fetal growth. We show that this belief reflects incomplete information about growth and the use of inappropriate measuring techniques by investigators. We have done this using illustrations drawn primarily from the Camden Study, a controlled, prospective study of nutrition and growth during adolescent pregnancy. Maternal growth during pregnancy is prevalent and associated with increased gestational weight gain. In the postpartum period it is associated with increased triceps skinfolds, arm fat area and weight retention, all of which occur at caloric intakes comparable with those of pregnant, non-growing adolescents and mature women. Unlike pregnancy where research is continuing, the sequelae of maternal growth during lactation are virtually unstudied. Inaccurate inferences about maternal growth based on measurements in medical records and the inability of traditional measuring techniques (e.g. serial measurements of stature) to detect maternal growth led many clinicians to erroneously believe that the limited statural growth in young pregnant women probably does not change maternal nutritional status or jeopardize fetal growth. In Camden, New Jersey, clinicians used the knee high measuring device during pregnancy and the postpartum period to measure the lower leg of pregnant adolescents and mature controls so they could monitor maternal growth during pregnancy. They measured the lower leg because it is less susceptible to the effects of gestational weight gain and forward curvature of the spine during pregnancy. Pregnant adolescents exhibited considerable positive increments in knee height growth while mature controls exhibited small decrements. So pregnant teens are growing in knee height but shrinking in stature as a result of weight gain and lordosis, suggesting that limited or no maternal growth occurs. Caloric intakes of the growing and nongrowing adolescents and the mature controls are essentially the same. Six weeks after delivery, adolescents who grow in knee height during pregnancy retain significantly more weight (3 kg more) than those who do not grow in knee height (p 0.01), indicating that greater weight retention is linked to maternal growth. The triceps of postpartum adolescents arm much larger and the arm fat area much greater in those who grow during pregnancy (p 0.05). Maternal growth in knee height during pregnancy is related to reduced infant birth weight, indicating that fat reserves in growing pregnant teens do not support fetal growth but support the mother's continued development. Few studies have examined growth and health status of breast feeding adolescents. This is an area that needs to be studied.
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