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Title: Adolescent pregnancy and nutrition: A subgroup analysis from the Mamachiponde study in Malawi

Author
item FRIEBERT, ALYSSA - CALIFORNIA POLYTECHNIC STATE UNIVERSITY
item CALLAGHAN-GILLESPIE, MEGHAN - WASHINGTON UNIVERSITY
item PAPATHAKIS, PEGGY - CALIFORNIA POLYTECHNIC STATE UNIVERSITY
item MANARY, MARK - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)

Submitted to: Annals of the New York Academy of Sciences
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/10/2017
Publication Date: 3/25/2018
Citation: Friebert, A., Callaghan-Gillespie, M., Papathakis, P.C., Manary, M.J. 2018. Adolescent pregnancy and nutrition: A subgroup analysis from the Mamachiponde study in Malawi. Annals of the New York Academy of Sciences. 1416(1):140-146. https://doi.org/10.1111/nyas.13465.
DOI: https://doi.org/10.1111/nyas.13465

Interpretive Summary: Delivering a child under the age of 19 is common in developing countries and associated with poor birth outcomes. Pregnant Malawian women with moderate malnutrition =18 years, 18-20 years and >20 years were given one of three supplementary foods. This study found that all women under 20 years had better nutritional status than women over 20, but the younger the mother, the smaller the length of their infant when measured at 6 and 12 weeks after birth.

Technical Abstract: Young age at childbearing (<=19 years) is common and associated with poor birth outcomes. A trial among Malawian pregnant women with moderate malnutrition was used to determine outcomes of young adolescents (<=18 years), older adolescents (18-20 years), and adults (>20 years). Women received one of three supplementary foods that provided approximately 900 kcal/day and 33-36 g protein/day and returned every 2 weeks. Newborn/maternal measurements were taken at delivery and after 6 and 12 weeks. Upon enrollment, adolescents had greater body mass index than adults (19.9 +/- 1.3 versus 19.5 +/- 1.4 kg/m(2) , P < 0.001). Young adolescents received more rations of food and enrolled and delivered with a lower fundal height than adults (21.7 +/- 5.2 versus 23.0 +/- 5.6, P = 0.00 enrollment; 30.2 +/- 3.1 versus 31.0 +/- 2.8, P < 0.001 delivery). Among newborns, length for age was lowest in young adolescents, greater in older adolescents, and greatest in adults (Z-scores -1.7 +/- 1.2, -1.4 +/- 1.2, and -1.1 +/- 1.1, respectively; P < 0.001). These differences persisted in length for age at 6 and 12 weeks of age for infants. Adolescents enrolled earlier in pregnancy and appeared more nutritionally adequate than adults; adolescent outcomes were inferior to those of adults, suggesting that they were subject to more physiologic stressors and/or different nutritional needs.