Adolescent pregnancy and gestational weight gain: do the Institute of Medicine recommendations apply?

OBJECTIVE: The purpose of this study was to examine the Institute of Medicine (IOM) guidelines for gestational weight gain in adolescents. STUDY DESIGN: We studied a retrospective cohort using the Missouri Birth Certificate Registry and included subjects who were primiparous, who had singleton gestations, who were <20 years old, and who delivered at 24-44 weeks gestation. The exposure was defined as weight gain less than, within, or greater than IOM recommendations. Outcomes that were examined were small-for-gestational-age (SGA) infants, large-for-gestational age (LGA) infants, preterm delivery, infant death, preeclampsia, cesarean delivery, and operative vaginal delivery. The analysis was stratified by body mass index category. RESULTS: In any body mass index category, inadequate weight gain was associated with increased odds of SGA infants, preterm delivery, and infant death. When subjects gained more than the IOM recommendations, the number of SGA infants decreased, with slight increases in the number of LGA infants, preeclampsia, and cesarean delivery. CONCLUSION: Adolescents should be counseled regarding adequate weight gain in pregnancy. Further research is necessary to determine whether the IOM recommendations recommend enough weight gain in adolescents to optimize pregnancy outcomes.