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Paediatr Perinat Epidemiol. 1997 Jan;11 Suppl 1:130-41.

Adolescent age at first pregnancy and subsequent obesity.

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Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, USA.


Adolescent pregnancy has been associated with subsequent obesity. This paper examines the patterns of obesity for second and third pregnancies among women who had their first singleton pregnancy as teenagers. We used maternally-linked data from 1978 to 1990 among 43,160 Missouri resident women. Age, parity, interpregnancy interval and prior body mass index were significantly associated with subsequent obesity among adolescents. Race, marital status and smoking had significant interactions with age. Among older women, being African-American and never having married was associated with an increased probability of obesity, and smoking had a greater effect on obesity at higher maternal age. Race and marital status did not have significant effects on obesity among younger women. The most important predictor of obesity was prior body mass index. Body mass index before the first pregnancy had a greater effect on subsequent obesity if the intervening interpregnancy weight gains were large. Excessive weight gain during pregnancy presents the health care provider with a dilemma. An increase in birthweight associated with high prenatal weight gains may diminish the risk of infant mortality and morbidity in an index pregnancy, but subsequent obesity may increase perinatal mortality rates, the rates of obstetric problems and neural tube defects.


This study examines the prevalence of obesity among American women who had an adolescent pregnancy in Missouri. Data were obtained from a maternally-linked longitudinal data set for the period 1978-90. The sample includes 103,262 births for first through fifth order singleton pregnancies linked to 43,160 Missouri mothers with a first pregnancy before the age of 20 years. Findings indicate that all women had at least two pregnancies. 31% had three pregnancies, 7% had four pregnancies, and 1% had five pregnancies. 8% were aged under 15 years at the first pregnancy, 35% were aged 16-17 years, and 57% were aged 18-19 years. A significantly higher number of higher birth order women had their first pregnancy when aged under 16 years. African American women were more likely to have their first pregnancy under 15 years of age, while White women were more likely to have their first pregnancy at 19 years. Medical risk factors decreased with age and increased with birth order. Cigarette smoking increased with age and with each pregnancy for all women. White women smoked more at every age and birth order. The rates of women in a subsample on Medicaid and food stamps decreased with age and increased with birth order. Rates of obesity increased with birth order. Rates increased from 3.8% for the first pregnancy to 16% for the fourth pregnancy. Women who were underweight at their first pregnancy had only a 0.5% increase in the rate of obesity from the first to second pregnancy, but overweight women had a 44.9% increase, and obese women had a 21% decrease in the rate of obesity. From the second to the fifth pregnancy, underweight women's rates of obesity are identified. Prior to the second and third pregnancy, the significant predictors of obesity were body mass index before the first pregnancy, interpregnancy weight gain, interpregnancy interval, race, medical risk factors, marital status, and smoking.

[Indexed for MEDLINE]

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