Adolescent pregnancy and nutrition: a subgroup analysis from the Mamachiponde study in Malawi

Young age at childbearing (<= 19 years) is common and associated with poor birth outcomes. A trial among Malawian pregnant women with moderate malnutrition was used to determine outcomes of young adolescents (<= 18 years), older adolescents (18-20 years), and adults (>20 years). Women received one of three supplementary foods that provided similar to 900 kcal/day and 33-36 g protein/day and returned every 2 weeks. Newborn/maternal measurements were taken at delivery and after 6 and 12 weeks. Upon enrollment, adolescents had greater body mass index than adults (19.9 +/- 1.3 versus 19.5 +/- 1.4 kg/m(2), P < 0.001). Young adolescents received more rations of food and enrolled and delivered with a lower fundal height than adults (21.7 +/- 5.2 versus 23.0 +/- 5.6, P = 0.00 enrollment; 30.2 +/- 3.1 versus 31.0 +/- 2.8, P < 0.001 delivery). Among newborns, length for age was lowest in young adolescents, greater in older adolescents, and greatest in adults (Z-scores -1.7 +/- 1.2, -1.4 +/- 1.2, and -1.1 +/- 1.1, respectively; P < 0.001). These differences persisted in length for age at 6 and 12 weeks of age for infants. Adolescents enrolled earlier in pregnancy and appeared more nutritionally adequate than adults; adolescent outcomes were inferior to those of adults, suggesting that they were subject to more physiologic stressors and/or different nutritional needs.