Promoting a Healthy Teenage

Pregnancy

Jennifer Hillan, MSH, RD, LD/N

Family, Youth, and Community Sciences

University of Florida/IFAS

Facts and Figures• Teenage birth rates are declining in U.S.• U.S. rates are highest among developed countries.• Nearly 12% of all U.S. births in 2000 were to teens.• Florida teen birth rate higher than U.S. average.(53.5 vs. 49.6 births per 1000 15-19 year olds in 1999) • Poor and low-income teens have highest birth

rates.National Center for Health Statistics, 2001Lenders et al, 2000

Behaviors of Teen Moms

• Compared to pregnant adults, pregnant teens are more likely to:– Receive late or no prenatal care– Use tobacco

National Center for Health Statistics, 2002

Prenatal Care is Important• Best way to have a healthy baby.• Manages both preexisting and

pregnancy-related health

conditions.• Evaluates risk of poor pregnancy outcome.• Health risks to mother and baby increase if

late or no prenatal care.

Alcohol, Tobacco & Other DrugsUse can lead to low birth weight, premature

delivery, growth retardation, learning disorders, birth defects, miscarriage, or infant death.No “safe” level of smoking; even 1-5 cigarettes

per day can have harmful effects.

National Center for Health Statistics, 2002

Risks for Mom

Pregnant teens are at increased risk for health complications such as:– Anemia– High blood pressure– Premature labor

Risks for BabyBabies born to teens are twice as likely to be

premature and of low birth weight.

Increased risk of developmental delays, serious and long-term illnesses, and death.

Infant death rate is three times higher in teen than in adult pregnancies.

Rees, Lederman, Kiely, 1996

Weight Gain RecommendationsPrepregnancy BMI (kg/m2) Weight Gain

Low (<19.8) 28-40 pounds

Normal (19.8-26) 25-35 pounds

High (>26-29) 15-25 pounds

Obese (>29) At least 15 pounds

Teens should strive for weight gain at upper end of ranges to support own and baby’s needs for growth and development.Institute of Medicine of the National Academy of Sciences, 1990

Weight Loss During Pregnancy• Teenagers are often worried about weight

gain.• Pregnancy is not the time for dieting or weight

loss, even for obese females.Dieting deprives the body of important nutrients

needed for growth & development.

• Focus should be on adapting a healthy lifestyle, including the right amount of healthful foods.

Pregnant Teens at Nutritional Risk• Mom is still growing and her needs for growth

& development are compromised by baby’s needs for growth & development.

Mother and baby compete for nutrients.• Pregnant teens often have diets low in iron,

zinc, calcium, folate, magnesium, vitamin D, and vitamin E.

Giddens at al, 2000

Nutrition for Pregnant Teens• Increased energy needs (+300 Kcals)

• Increased protein needs (+14-16 g)This amount is usually met by average American

diet.

• Increased need for many vitamins and minerals

• Focus on nutrient-dense foods

Nutrients of Special ConcernCalcium (1300 mg/day for all girls 9-18)

• Calcium absorption is increased during pregnancy, so recommendations are same for pregnant and nonpregnant teens.

• Teens often have low calcium intakes.• Increased calcium intakes have been

associated with lower rates of pregnancy-induced hypertension and premature delivery.

Ortega et al, 1999; Repke and Villar, 1991

Nutrients of Special ConcernFolate (600 g/day for pregnant teens and adults)

• Teens often have low folate intakes.

• Helps prevent neural tube defects.

• Good sources include oranges and orange juice, lentils and dry beans, green leafy vegetables, fortified cereals.

Nutrients of Special ConcernIron (27 mg/day for pregnant teens and adults)

• Teens often have low iron intakes.• Needs are greatly increased during pregnancy.• Most common deficiency in pregnancy.• Iron-deficiency anemia is associated with

premature delivery, low birth weight, and increased rates of infant death.

• Supplement recommended.

Food and Nutrition Board of the National Academy of Sciences, 2000

Food Guide PyramidWith the exception of iron and possibly folate, nutrient needs can be met through smart food choices from the FGP.

FGP Recommendations for Pregnant Teens

Food GroupNo. of Servings Daily

Bread, cereal, rice & pasta 9 or more

Vegetable 4 or more

Fruit 3 or more

Milk, yogurt & cheese 4

Meat, poultry, fish, dry beans, eggs & nuts 2-3

Fats, oils & sweets Use sparingly

Food Safety During Pregnancy• Pregnant women are at high risk for

listeriosis, a foodborne illness caused by Listeria monocytogenes.

• Listeriosis can have serious effects, including miscarriage.

Food Safety During Pregnancy• Toxoplasmosis, caused by the parasite

Toxoplasma gondii, is also a special concern during pregnancy.

• Toxoplasmosis can be passed to the fetus and cause blindness and retardation.

• In addition to raw meat, Toxoplasma can also be present in soil and cat litter.

Food Safety During PregnancyTo reduce the risk of foodborne illness, pregnant

women should avoid:• unpasteurized milk and milk products• soft cheeses such as feta, Brie, Camembert, blue-

veined, and Mexican-stylePasteurized processed cheese slices and spreads, cream

cheese, and cottage cheese are OK.

• cold, ready-to-eat hot dogs & luncheon (deli) meatsThese meats are OK if they are heated until steaming hot.

Food Safety During PregnancyMore foods to avoid:

• raw or undercooked meat, poultry, or seafood

• refrigerated smoked seafood or seafood spreads, and pate

Canned meat and seafood are OK.

• UNWASHED fruits and vegetables

Additional Precautions Against Toxoplasmosis

Pregnant women should:• wear gloves if handling soil• have someone else clean cat litter

– If that’s not possible, wear gloves and immediately wash hands afterwards.

– Clean cat box daily, since infection can only occur a few days after feces is passed.

Breastfeeding• Many benefits for both mom and baby.• More teens try breastfeeding after

receiving breastfeeding education.• Teens who become pregnant shortly after

first menstruation may have immature mammary glands and/or not enough breast tissue for successful lactation.

Volpe and Bear, 2000

Recommendations for a Healthy Pregnancy

Teens should be encouraged to:• seek medical care as soon as pregnancy is suspected • avoid the use of tobacco, alcohol, or other drugs• follow weight gain recommendations • take supplements as prescribed by health care provider• follow the Food Guide Pyramid and eat a variety of foods• receive breastfeeding education

Resources for Educators and Consumers….

UF/IFAS Publications• FCS1068 – Easing the Discomforts of Pregn

ancy

• FCS8564 – Eating for a Healthy Pregnancy

• FCS8726 – Benefits of Breastfeeding

• FCS8729 – Oral Health for Pregnant Women

Additional Resources• Bibliography of Adolescent Prenatal Care

from the National Center for Maternal and Child Health: http://www.ncemch.org/databases/Bibmenu.html

• Database of Teenage Pregnancy resources from MedlinePlus, National Library of Medicine: http://medlineplus.gov/