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