Nutritional modulation of adolescent pregnancy outcome

A review

Jacqueline Wallace, J S Luther, John Milne, Raymond Aitken, D A Redmer, L P Reynolds, W W Hay

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

The risks of miscarriage, prematurity and low birth weight are particularly acute in adolescent girls who are still growing at the time of conception. The role of maternal nutrition in mediating pregnancy outcome in this vulnerable group has been examined in sheep models. When singleton bearing adolescent dams arc overnourished to promote rapid maternal growth throughout pregnancy, growth of both the placenta and fetus is impaired, and birth occurs prematurely relative to control adolescents of equivalent age. Studies at mid-gestation, prior to alterations in placental mass, Suggest that reduced prolifieration of the fetal trophectoderm, impaired angiogenesis, and attenuated uteroplacental blood flows are early defects in placental development. By late pregnancy, relative placental mass is reduced by 45% but uteroplacental metabolism and placental glucose transfer capacity remain normal when expressed on a placental weight specific basis. The asymmetrically growth-restricted fetuses are hypoxic, hypoglycemic and have reduced insulin and IGP-1 concentrations. Absolute umbilical nutrient uptakes are attenuated but fetal utilisation of glucose, oxygen and amino acids remains normal on a fetal weight basis. This suggests altered sensitivities to metabolic signals and may have implications for subsequent metabolic health. At the other end of the nutritional spectrum, many girls who become pregnant have inadequate or marginal nutritional status during pregnancy. This situation is replicated in a second model whereby darns are prevented from growing during pregnancy by relatively underfeeding. Limiting maternal intake in this way gradually depletes maternal body reserves leading to a lower transplacental glucose gradient and a modest slowing of fetal growth in late pregnancy. These changes appear to be independent of alterations in placental growth per se. Thus, while the underlying mechanisms differ, maternal intake at both ends of the nutritional spectrum is a powerful determinant of fetal growth in pregnant adolescents.

Original languageEnglish
Pages (from-to)61-68
Number of pages8
JournalPlacenta
Volume27
Issue numberSupplement
Early online date25 Jan 2006
DOIs
Publication statusPublished - Apr 2006

Keywords

  • adolescent pregnancy
  • nutrition
  • placental growth
  • fetal growth
  • placental growth restriction
  • carrying singleton fetuses
  • growing adolescent
  • fetal-growth
  • maternal growth
  • teenage pregnancies
  • angiogenic factors
  • hormone treatment
  • endocrine status
  • sheep

Cite this

Wallace, J., Luther, J. S., Milne, J., Aitken, R., Redmer, D. A., Reynolds, L. P., & Hay, W. W. (2006). Nutritional modulation of adolescent pregnancy outcome: A review. Placenta, 27(Supplement), 61-68. https://doi.org/10.1016/j.placenta.2005.12.002

Nutritional modulation of adolescent pregnancy outcome : A review. / Wallace, Jacqueline; Luther, J S ; Milne, John; Aitken, Raymond; Redmer, D A ; Reynolds, L P ; Hay, W W .

In: Placenta, Vol. 27, No. Supplement, 04.2006, p. 61-68.

Research output: Contribution to journalArticle

Wallace, J, Luther, JS, Milne, J, Aitken, R, Redmer, DA, Reynolds, LP & Hay, WW 2006, 'Nutritional modulation of adolescent pregnancy outcome: A review', Placenta, vol. 27, no. Supplement, pp. 61-68. https://doi.org/10.1016/j.placenta.2005.12.002
Wallace J, Luther JS, Milne J, Aitken R, Redmer DA, Reynolds LP et al. Nutritional modulation of adolescent pregnancy outcome: A review. Placenta. 2006 Apr;27(Supplement):61-68. https://doi.org/10.1016/j.placenta.2005.12.002
Wallace, Jacqueline ; Luther, J S ; Milne, John ; Aitken, Raymond ; Redmer, D A ; Reynolds, L P ; Hay, W W . / Nutritional modulation of adolescent pregnancy outcome : A review. In: Placenta. 2006 ; Vol. 27, No. Supplement. pp. 61-68.
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