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Study Objective: Regular physical activity (PA) during pregnancy decreases the risk of gestational hypertension and preeclampsia. Currently, little is known about the PA of pregnant adolescents. Our intent was to characterize the PA behaviors of a group of racially diverse, low-income pregnant teens and to identify potential determinants of PA., Design, Setting, Participants, and Interventions: A cohort of 157 racially diverse pregnant adolescents (13-18 years of age) completed up to 3 previous day PA recalls as part of a larger prospective longitudinal study on determinants of maternal and fetal bone health. Subjects self-reported activities from 7 AM to 11:30 PM, choosing from a list of 37 activities including a category for "other." Subjects recorded activities in 30-minute intervals., Main Outcome Measures: Estimated metabolic equivalent task (MET) values were assigned to each activity and summed for a measure of total daily PA in MET min/d. Determinants of PA were evaluated using a stepwise linear mixed effect model., Results: The average calculated MET min/d was 1478 ± 130. Significant determinants of MET min/d included race (P = .007), maternal age at conception (P = .042), gestational age (P = .002), and attending school (P < .001). Black teens were less physically active than white teens, and older teens were more active than younger teens; activity decreased throughout gestation, and teens currently attending school were more active., Conclusion: PA is low across gestation and pregnant teens spent more than half of their monitored time in sedentary activities. Targeted interventions are needed to achieve current PA goals in this pediatric obstetric population., (Copyright © 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

Type 1 diabetes (T1D) is associated with skeletal abnormalities including low bone density and increased fracture risk. The pathophysiology underlying T1D related skeletal fragility remains unknown. The objective of this study was to use a dual-stable calcium isotope method to investigate the effects of T1D on calcium absorption and estimated calcium retention in adolescent females. Twenty adolescent females with T1D were admitted for a 24-h calcium absorption study using oral ( 44 Ca) and intravenous ( 42 Ca) stable isotopes for determination of percent gastrointestinal calcium absorption and estimated calcium retention. Five out of twenty participants were found to have negative estimated calcium retention. Participants with negative calcium retention had greater urinary calcium excretion [202mg/d (IQR: 178-213)] compared to those with positive calcium retention [101.5mg/d (IQR: 82-122)], p=0.01, but similar calcium intake and percent calcium absorption. With the exception of one outlier, 24-h urine calcium was significantly associated with hemoglobin A1c (Pearson's r=0.55, p=0.02). 50% of participants consumed less than the RDA for calcium; fractional calcium absorption was inversely correlated with calcium intake in participants not meeting the RDA (Spearman's rho -0.65, p=0.04). In conclusion, one-quarter of adolescent girls with T1D were found to have negative estimated calcium retention at a time when bone mineral accrual should be ongoing. This appeared to be the result of excess urinary calcium excretion as opposed to diminished gastrointestinal calcium absorption. Insufficient calcium availability for bone deposition during adolescence could impair bone mineral accrual and contribute to skeletal fragility. Trial registered: ClinicalTrials.gov Reg No. NCT03156179., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Study Objective: Our objective was to identify risk factors associated with maternal infections and placental inflammation in pregnant adolescents attending an urban adolescent maternity clinic., Design: This cross-sectional, descriptive study used survey and medical chart data collected at entry and prospectively across gestation. The prevalence of maternal infections and placental inflammation was determined and potential risk factors were identified., Setting: Rochester Adolescent Maternal Program (RAMP) in Rochester, NY., Participants: Racially and ethnically diverse pregnant adolescents (n = 158 ≤ 18 y at entry) were recruited., Interventions and Main Outcome Measures: Main outcome measures were diagnosis of an infection or inflammatory condition in relation to demographic, anthropometric, dietary, socioeconomic, and health data., Results: The three most prevalent infections diagnosed in this study population were recto-vaginal colonization of group B Streptococcus (GBS) (38%), bacterial vaginosis (BV) (40%) and candida (42%). African-American teens (AOR = 4.6; 95% CI: 1.74-13.02) and those with higher pre-pregnancy BMI (ppBMI; AOR = 1.2; 95% CI: 1.04-1.31) were more likely to test positive for BV across gestation. Older maternal age decreased the likelihood of positive tests for trichomoniasis (OR = 0.51; 95% CI: 0.26-0.92) and gonorrhea (OR = 0.38; 95% CI: 0.16-0.82). Higher mean dietary vitamin D intake (mcg/d) was associated with a lower likelihood of testing positive for recto-vaginal GBS (OR = 0.87; 95% CI: 0.77-0.98)., Conclusion: Addressing modifiable risk factors associated with dietary intake and pre-pregnancy weight may help reduce health disparities among pregnant minority adolescents. Additionally, targeted sexual health education may greatly benefit younger female adolescents., (Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

Study Objective: To provide a brief assessment of dietary beliefs and behaviors in an understudied high-risk population of pregnant adolescents., Design, Setting, and Participants: Diverse pregnant adolescents (n = 66) recruited from the Rochester Adolescent Maternity Program at the University of Rochester Medical Center in Rochester, New York completed a nutrition knowledge and beliefs survey once during pregnancy., Interventions and Main Outcome Measures: Responses were recorded by a health project coordinator who had good rapport with the teens. Study staff evaluated responses for emergent themes and thematically coded survey data. All responses were assessed relative to demographic variables using χ(2) and analysis of variance tests., Results: Most (83%; 55/66) pregnant teens self-identified as African American with 21% (14/66) identifying as Hispanic. Most (92%; 61/66) adolescents had medical insurance and 28% (19/66) reported participating in the Supplemental Nutrition Program for Women, Infants, and Children. The importance of proper nutrition was acknowledged but 14% (9/66) reported that diet did not matter or they were unsure of the importance of nutrition for the fetus. Money, access to food, and personal relationships were reported as constraining factors for a healthy diet. Response themes did not differ according to demographic characteristics., Conclusion: Overall, pregnant teens recognize the importance of dietary intake during pregnancy but this knowledge does not always translate into behaviors. Understanding the health knowledge and behaviors of pregnant adolescents might provide a foundation for future lifestyle and clinical interventions., (Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

Study Objective: Recent attention has focused on vitamin D insufficiency but few data exist on vitamin D status among pregnant minority youth., Design: A screening study was undertaken in adolescents having prenatal blood samples drawn for other routine tests obtained during the second trimester (18+/-1.8 week gestation, n=44) or third trimester of pregnancy (28.4+/-2.1 week gestation, n=36). Serum 25- hydroxyvitamin D (25(OH)D) was measured and significant determinants of vitamin D insufficiency in this cohort were identified., Setting: Urban prenatal clinic., Participants: Eighty pregnant African American adolescents (< or = 18 y of age)., Main Outcome Measure(s): Vitamin D status, STDs, hemoglobin, season, birth weight, Results: Serum 25(OH)D in this group averaged 21.6+/-8 ng/mL (age 16.5+/-1.1 y, n=80), and did not significantly differ between the second (20.95+/-8.2 ng/mL, n=44) and third trimester cohorts (22.5+/-7.9 ng/mL, n=36). Vitamin D insufficiency (< 20 ng/mL) was evident in 46.25% and vitamin D deficiency (<15 ng/mL) was evident in 21.25% of those studied. Significant predictors of suboptimal vitamin D status included sampling during the winter months (P=0.004), lower hemoglobin concentration (P=0.019), and higher second trimester leptin levels (P=0.018). Inverse associations between 25(OH)D and bacterial vaginosis were evident when controlled for season of sampling (P=0.02, n=80)., Conclusions: Vitamin D insufficiency was prevalent among urban pregnant minority adolescents. Further studies are needed to address the impact of this finding on maternal and neonatal calcium homeostasis and bone health., (Copyright 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)