title: Interventions to improve diet and weight gain among pregnant adolescents and recommendations for future research.
abstract: Pregnant adolescents are at particular risk for both inadequate and excessive gestational weight gain and for inadequate intake of micronutrients that support healthy fetal development. This article reviews the available literature on prenatal nutrition interventions intended to address such risks to identify effective strategies and needs for further research. A medical model providing enhanced prenatal care aimed at improved birth weight predominated. No studies rigorously evaluated the independent influence of nutrition education on prenatal dietary behaviors or outcomes; few applied a conceptual framework or targeted dietary attitudes, behaviors, skills, or self-efficacy. Positive effect on birth outcomes was evident, likely due to multidisciplinary teams supporting the special psychosocial needs of pregnant adolescents; individualized education and counseling encouraging optimal dietary choice and appropriate gestational weight gain; home visits providing prenatal education, support, and outreach to highest-risk teens; visual presentation and tracking of gestational weight gain; and support/discussion groups. Nevertheless, greater effects could likely be achieved by applying behavior-change strategies that have been implemented effectively with other, similar populations. Further research is needed to test such approaches with pregnant, high-risk teens.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for Human Nutrition, Baltimore, MD 21205, USA. jnielsen@jhsph.edu
authors.forename: Jennifer Notkin
authors.initials: JN
authors.lastname: Nielsen
authors.forename: Joel
authors.initials: J
authors.lastname: Gittelsohn
authors.forename: Jean
authors.initials: J
authors.lastname: Anliker
authors.forename: Kimberly
authors.initials: K
authors.lastname: O'Brien
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D017195:Adolescent Nutritional Physiological Phenomena / Q000502:physiology*; D001724:Birth Weight; D004032:Diet / Q000592:standards*; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018673:Nutrition Policy; D009751:Nutritional Requirements; D011247:Pregnancy; D039401:Prenatal Nutritional Physiological Phenomena / Q000502:physiology*; D012307:Risk Factors; D020377:Self Efficacy; D015430:Weight Gain / Q000502:physiology*