title: Adolescent pregnancy and gestational weight gain: do the Institute of Medicine recommendations apply?
abstract: OBJECTIVE
  The purpose of this study was to examine the Institute of Medicine (IOM) guidelines for gestational weight gain in adolescents.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, MO, USA.
authors.forename: Lorie M
authors.initials: LM
authors.lastname: Harper
authors.forename: Jen Jen
authors.initials: JJ
authors.lastname: Chang
authors.forename: George A
authors.initials: GA
authors.lastname: Macones
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D008429:Maternal Welfare; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D016017:Odds Ratio; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000453:epidemiology; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence; D047928:Premature Birth; D012016:Reference Values; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D014481:United States; D015430:Weight Gain / Q000502:physiology*