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This study, involving 127 poor black pregnant girls (12 to 18 years old) of whom 33% reported previous physical or sexual abuse, found that abused adolescents scored significantly higher on stress and depression scales and rated their families as less supportive than did nonabused adolescents. Abused adolescents were also more likely to report substance abuse during pregnancy. (Author/DB)

Younger pregnant teenage girls may transfer more of their weight gain to their fetus than older pregnant teenage girls. Researchers examined the relationship between maternal weight gain and infant birth weight in black low-income teenage girls and their infants. Among 141 teenage girls, 52 were under 16 years old and 89 were between 16 and 19 years old at the time of conception. A significant association was found between weight gain during pregnancy and infant birth weight in the younger girls, but not in the older girls. More maternal weight gain was transferred to the fetus in the younger girls than in the older girls. The infant birth weight increased with the amount of weight gained during pregnancy in the younger girls.

Day-care programs for children of adolescent mothers should address the needs of both the children and their mothers. Adolescent mothers are usually completing their own education and establishing financial independence during their child's formative years. Children of adolescent mothers have a higher risk of developmental and behavioral problems than children of adult mothers. They may also have slower intellectual development than other children. These problems may be caused by a reduced ability of adolescent mothers to communicate and interact with their children. Day-care programs for children of adolescent mothers should ideally be located near the mother's high school or workplace. They should include different types of instruction to teach young mothers the skills to care for and nurture their children. These skills should include learning to communicate and interact with their children.

* Objective.--To clarify the advantages and disadvantages of large gestational weight gain among pregnant adolescents. Design.--Prospective, longitudinal survey. Setting.--Adolescent-oriented maternity program in Rochester, NY. Participants.--One hundred forty-one poor, black, pregnant 12- through 19-year-olds grouped according to rate of gestational weight gain. Slow weight gain was defined as weight gain of less than 0.23 kg per week; average, 0.23 to 0.4 kg per week; and rapid, more than 0.4 kg per week. Interventions.--None. Measurements/Main Results.--Infants of rapid weight-gainers were significantly larger than infants of slower weight-gainers but did not experience fewer perinatal complications than other infants. Infants of slow weight-gainers were significantly smaller than infants of average and rapid weight-gainers and experienced more perinatal complications than other infants. Adolescents who gained weight rapidly retained more weight and, therefore, were more often obese after pregnancy. Conclusions.--The advantages of large weight gains for pregnant adolescents and their infants are well-documented; this study demonstrates the importance of balancing the long-term potential morbidity of maternal obesity against the benefits of enhanced fetal growth in formulating weight-gain recommendations for pregnant adolescents. (AJDC. 1992;146:1359-1364)

Maternal weight gain, one of the most important determinants of infant birth weight, is particularly interesting to health care providers because it can be modified during the prenatal period (1). [...]

Compared the choice of parenthood in 17 Black low-income adolescents and 53 White middle-class couples. Results showed the decision to become parents was related to subcultural values. In contrast to White adults, Black adolescents did not see marriage, completion of schooling, or economic independence as prerequisites for motherhood. (JAC)

Seventy-five normal primipatous mothers less than 20 years old were videotaped with their normal infants for 10 minutes during 3 days following birth. No relationship was found between adolescent maternal age and the count of maternal behaviors. (Author/CL)

The social maturation of adolescents with disabilities is examined in terms of early, middle, and late adolescence, and studies are reviewed on disabled adolescents' self-esteem/self concept, independence/dependence, sexuality, and social relationships with family, peers, and school. (CL)

In an effort to generate hypotheses on the increase in youth suicide in the United States, studies from other countries are reviewed, which relate suicide to factors within the general areas of the family, religion, transition and mobility, achievement motivation, and aggression. American trends in these areas are examined. (SJL)

Recommendations that young, pregnant teenagers gain up to 16 kilograms (kg) to prevent having low-birth-weight infants may put the teenagers at risk for subsequent obesity. In 1990, the Institute of Medicine's Committee on Nutritional Status During Pregnancy and Lactation issued a report on the association between maternal nutrition and weight gain and the health of newborn infants. The report included recommendations that pregnant women gain between 11.5 and 16 kg, and that young teenagers should gain as much as possible within this range. However, studies have shown that women who gain excessive weight during pregnancy retain more weight after childbirth. Also, the incidence of teenage obesity has been increasing, especially among African American girls. Further study is needed on the relationship between weight gain in pregnancy and risk of obesity before greater weight gain is recommended.

Most patients do not report substance use reliably during pregnancy (1-3). In one study, reliance on patient self-reports resulted in the misclassification of more than 25% of pregnant cocaine users [...]

Accurate determination of maternal prepregnant body size is critical (l). Prepregnant weight and height are usually reported by the pregnant woman when the prenatal history is taken. Studies indicate that [...]

Pregnant teenagers start prenatal care later than adults. It is thought that the reasons for this are psychosocial. However, this study shows that pregnant teenagers reported vaginal bleeding in their first eight weeks of pregnancy more often than adults (16.9 percent compared with 5.7 percent). The teenagers with vaginal bleeding do not realize they are pregnant. The number of teenagers who had vaginal bleeding started prenatal care later than those who did not have the bleeding (16.2 weeks compared with 12.7 weeks). Data were complied from 136 black teenagers and 53 adults, the majority of whom were pregnant for the first time, unmarried and poor. The age-related difference in vaginal bleeding early in pregnancy may be related to the concentration of hormones. Menstruation is often more irregular in adolescents than adults. Adolescents must be taught that menstrual irregularities may be a symptom of pregnancy. If the age of the fetus is determined by the date of the last menstrual period, a larger number of babies thought to be born prematurely are really full-term. (Consumer Summary produced by Reliance Medical Information, Inc.)

The availability of preventive-service guidelines for adolescents lagged behind the availability of well-child guidelines for younger children until the introduction of the Guidelines for Adolescent Preventive Services (GAPS) in 1994. [...]

Daily cigarette smoking is more likely to be reported by girls who are high school seniors than by boys of the same age (20 versus 16 percent, respectively). In the 12- to 17-year-old age group, white teenagers are more likely than minority teenagers to smoke cigarettes. It is known that teenagers who engage in early and unprotected sex are more likely to smoke (cigarettes and marijuana) and to do poorly in school. This implies that a pregnant adolescent should be carefully screened for behaviors that put her and her fetus at risk. An article by Davis and colleagues published in the December 1990 issue of the American Journal of Diseases of Children reports on trends in smoking by adolescents during pregnancy. Their analysis showed a small but significant increase in smoking during pregnancy between 1984 (32 percent) and 1988 (37 percent). It was found that white pregnant girls were 1.5 times more likely to smoke than black pregnant girls, and five times more likely to smoke than Hispanic pregnant girls. There is a need to direct programs on preventing or stopping smoking to the pregnant teenagers. It is important to ask why teenage girls are at such high risk for starting to smoke, and to determine what approaches would be most helpful in decreasing the use of cigarettes. Potential approaches include targeting families where parents smoke; children from these families are known to be more likely to begin smoking. Appearance is important to teenagers; perhaps cigarette advertising has convinced the teenage girl that smoking enhances her image. Smoking education can be initiated when medical care is sought for contraception, pregnancy or psychological stress and depression. (Consumer Summary produced by Reliance Medical Information, Inc.)

Many pregnant adolescents are at risk for behavior problems. Elster et al. in the June 1990 issue of Pediatrics studied the relationship between adolescent parenthood and behavioral problems such as truancy, drug and alcohol abuse and fighting. These researchers came to the conclusion that adolescents who engaged in three or more problem behaviors were more likely to become a mother by the time they were 19 years of age. In addition, white urban teenagers reported more problem behaviors than blacks and Hispanics. A relationship between a history of problem behavior and future parenting difficulties is suggested by the authors of that study. Another approach might be to look at why these particular adolescents are engaging in such behavior and if any interventions can be implemented to prevent such behavior. One aspect that should be included is looking for common causes of problem behavior. One promising study has found that adolescents abuse drugs and alcohol to allay symptoms of depression. Perhaps teenagers are becoming sexually active at an early age in an effort to reduce stress and related depression. Early diagnosis of depression could help clinicians provide appropriate treatment for depression, which may in turn prevent problem behavior that can lead to poor parenting. (Consumer Summary produced by Reliance Medical Information, Inc.)