References

Atkinson L, Shaw RL, French DP. Is pregnancy a teachable moment for diet and physical activity behaviour change? An interpretative phenomenological analysis of the experiences of women during their first pregnancy. Br J Health Psychol.. 2016a; 21:(4)842-58 https://doi.org/10.1111/bjhp.12200

Atkinson L, Olander EK, French DP. Acceptability of a weight management intervention for pregnant and postpartum women with BMI ≥30 kg/m2: A qualitative evaluation of an individualized, home-based service. Matern Child Health J.. 2016b; 20:(1)88-96 https://doi.org/10.1007/s10995-015-1806-y

Baker PN, Wheeler SJ, Sanders TA A prospective study of micronutrient status in adolescent pregnancy. Am J Clin Nutr.. 2009; 89:(4)1114-24 https://doi.org/10.3945/ajcn.2008.27097

Baker AM, Haeri S. Estimating risk factors for spontaneous preterm delivery in teen pregnancies. Arch Gynecol Obstet. 2014; 289:(6)1203-6 https://doi.org/10.1007/s00404-014-3149-0

Barber C, Rankin J, Heslehurst N. Maternal body mass index and access to antenatal care: a retrospective analysis of 619,502 births in England. BMC Pregnancy Childbirth. 2017; 17:(1) https://doi.org/10.1186/s12884-017-1475-5

Chang T, Moniz MH, Plegue MA Characteristics of women age 15-24 at risk for excess weight gain during pregnancy. PLoS One. 2017; 12:(3) https://doi.org/10.1371/journal.pone.0173790

Dinwiddie KJ, Schillerstrom TL, Schillerstrom JE. Postpartum depression in adolescent mothers. J Psychosom Obstet Gynaecol.. 2018; 39:(3)168-75 https://doi.org/10.1080/0167482X.2017.1334051

Eating well in pregnancy: A practical guide to support teenagers.London: First Steps Nutrition Trust; 2013

Haakstad LAH, Torset B, Bø K. What is the effect of regular group exercise on maternal psychological outcomes and common pregnancy complaints? An assessor blinded RCT. Midwifery. 2016; 32:81-6 https://doi.org/10.1016/j.midw.2015.10.008

Hillier SE, Olander EK. Women's dietary changes before and during pregnancy: A systematic review. Midwifery. 2017; 49:19-31 https://doi.org/10.1016/j.midw.2017.01.014

Weight gain during pregnancy: reexamining the guidelines.Washington (DC): National Academy Press; 2009

Kansu-Celik H, Kisa Karakaya B, Guzel AI, Tasci Y, Erkaya S. To evaluate the effect of pre-pregnancy body mass index on maternal and perinatal outcomes among adolescent pregnant women. J Matern Fetal Neonatal Med. 2017; 30:(13)1574-8 https://doi.org/10.1080/14767058.2016.1214122

Kostanski M, Gullone E. Adolescent body image dissatisfaction: relationships with self-esteem, anxiety, and depression controlling for body mass. J Child Psychol Psychiatry. 1998; 39:(2)255-62 https://doi.org/10.1017/S0021963097001807

Leiferman J, Swibas T, Koiness K, Marshall JA, Dunn AL. My baby, my move: examination of perceived barriers and motivating factors related to antenatal physical activity. J Midwifery Womens Health. 2011; 56:(1)33-40 https://doi.org/10.1111/j.1542-2011.2010.00004.x

Macleod AJ, Weaver SM. Teenage pregnancy: Attitudes, social support and adjustment to pregnancy during the antenatal period. J Reprod Infant Psychol.. 2003; 21:(1)49-59 https://doi.org/10.1080/0264683021000060084

Marvin-Dowle K, Burley VJ, Soltani H. Nutrient intakes and nutritional biomarkers in pregnant adolescents: a systematic review of studies in developed countries. BMC Pregnancy Childbirth. 2016; 16:(1) https://doi.org/10.1186/s12884-016-1059-9

McCall SJ, Bhattacharya S, Okpo E, Macfarlne GJ. Evaluating the social determinants of teenage pregnancy: a temporal analysis using a UK obstetric database from 1950 to 2010. J Epidemiol Community Health. 2015; 69:49-54 https://doi.org/10.1136/jech-2014-204214

Michie S, van Stralen MM, West R. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implement Sci.. 2011; 6:(1) https://doi.org/10.1186/1748-5908-6-42

Moran VH. A systematic review of dietary assessments of pregnant adolescents in industrialised countries. Br J Nutr.. 2007; 97:(03)411-25 https://doi.org/10.1017/S0007114507381373

Weight management before, during and after pregnancy [PH27].London: NICE; 2010

NHS Digital. National Child measurement Programme—England, 2016-17. 2017. https://digital.nhs.uk/data-and-information/publications/statistical/national-child-measurement-programme/2016-17-school-year (accessed 26 November 2018)

Neiterman E, Fox B. Controlling the unruly maternal body: losing and gaining control over the body during pregnancy and the postpartum period. Soc Sci Med. 2017; 174:142-8 https://doi.org/10.1016/j.socscimed.2016.12.029

Nielsen JN, Gittelsohn J, Anliker J, O'Brien K. Interventions to improve diet and weight gain among pregnant adolescents and recommendations for future research. J Am Diet Assoc.. 2006; 106:(11)1825-40 https://doi.org/10.1016/j.jada.2006.08.007

Office For National Statistics. Conception statistics. England and Wales, 2015. 2017. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/conceptionandfertilityrates/datasets/conceptionstatisticsenglandandwalesreferencetables (accessed 8 November 2018)

Olander EK, Atkinson L, Edmunds JK, French DP. The views of pre- and post-natal women and health professionals regarding gestational weight gain: an exploratory study. Sex Reprod Healthc.. 2011; 2:(1)43-48 https://doi.org/10.1016/j.srhc.2010.10.004

Olander EK, Darwin ZJ, Atkinson L, Smith DM, Gardner B. Beyond the ‘teachable moment’ – A conceptual analysis of women's perinatal behaviour change. Women Birth. 2016; 29:(3)e67-71 https://doi.org/10.1016/j.wombi.2015.11.005

A framework for supporting teenage mothers and young fathers.London: PHE; 2016

Soltani H, Duxbury A, Rundle R, Marvin-Dowle K. Dietary habits and supplementation practices of young women during pregnancy: an online cross-sectional survey of young mothers and health care professionals. BMC Nutrition. 2017; 3:(1) https://doi.org/10.1186/s40795-017-0137-3

Thangaratinam S, Rogozinska E, Jolly K Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ.. 2012; 344 https://doi.org/10.1136/bmj.e2088

Whisner CM, Bruening M, O'Brien KO. A Brief Survey of Dietary Beliefs and Behaviors of Pregnant Adolescents. J Pediatr Adolesc Gynecol.. 2016; 29:(5)476-81 https://doi.org/10.1016/j.jpag.2016.03.002

Whitworth M, Cockerill R, Lamb H. Antenatal management of teenage pregnancy. Obstetrics, Gynaecol Reprod Med. 2017; 27:(2)50-6 https://doi.org/10.1016/j.ogrm.2016.11.005

Wise NJ. Pregnant adolescents, beliefs about healthy eating, factors that influence food choices, and nutrition education preferences. J Midwifery Womens Health. 2015; 60:(4)410-18 https://doi.org/10.1111/jmwh.12275

Wise NJ, Arcamone AA. Survey of adolescent views of healthy eating during pregnancy. MCN Am J Matern Child Nurs. 2011; 36:(6)381-6 https://doi.org/10.1097/NMC.0b013e31822f4778

Zaltzman A, Falcon B, Harrison ME. Body image in adolescent pregnancy. J Pediatr Adolesc Gynecol.. 2015; 28:(2)102-8 https://doi.org/10.1016/j.jpag.2014.06.003

Weight management during teenage pregnancy: Issues to consider when developing appropriate support

02 December 2018
Volume 26 · Issue 12

Abstract

Teenage pregnancy is more prevalent in areas of high obesity, compared to areas where obesity levels are low. Risks associated with maternal obesity in pregnant teenagers include pre-eclampsia and caesarean delivery. To reduce these risks, pregnant teenagers need to be supported to gain a healthy weight in pregnancy. This includes encouraging these women to eat healthily through providing appropriate information including online or smartphone apps in conjunction with face-to-face support. These young women also need encouragement to be physically active. This support must be tailored to the teenage population considering their specific barriers and facilitators to behaviour change. Midwives with the aid of a multidisciplinary team play a key role in encouraging these healthy behaviours.

Teenage pregnancy rates continue to decline in England, and are now at their lowest level since 1969 (Office for National Statistics, 2017). While this is heralded as a success, under-18 conception rates in England are still the highest of similar western European countries (Whitworth et al, 2017). Importantly, teenage pregnancy rates are high in areas of deprivation (Public Health England, 2016), clustering with other public health issues such as obesity. For example, areas of high childhood obesity also have high rates of teenage parenthood—with London being the anomaly, where childhood obesity is high and teenage parenthood low (Table 1). This article outlines the risks associated with obesity in pregnant teenagers and details how midwives can support these young women with managing their weight during pregnancy.

In 2016, 22 645 babies were born to mothers under the age of 20 in England and Wales (Office for National Statistics, 2017). Similar to adult pregnant women, maternal obesity is common in pregnant teenagers. A UK study of 2000 teenagers found about 20% of pregnant teenagers between 14-18 years to be overweight and 10% categorised as obese (Baker et al, 2009) in early pregnancy, based on age-adjusted classifications for teenage body mass index (BMI). While it has been suggested that maternal obesity may protect against preterm delivery in these young women (Baker and Haeri, 2014), it is also associated with risks such as pre-eclampsia, caesarean birth, and having a baby who is small for gestational age (Kansu-Celik et al, 2017).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month