Eighteen Years After Pregnancy Adolescent Gestational Weight Gain Still Affects Body Mass Index

Objective:  To examine the long-term effects of the gestational weight gain (GWG) of black primiparous adolescent girls on body mass index (BMI) and health perception 12 and 18 years after the birth of a first child.

Design: Secondary data analysis of data from a longitudinal randomized controlled trial (RCT).

Setting: Participants were enrolled in the New Mother’s Study, a large ongoing RCT in Memphis TN, testing the effectiveness of home visitation on the health and well being of women and their children.

Sample: A subgroup of primiparous black adolescent girls who delivered full term infants for whom data was available at the 12 year (n=258) and 18 year (n = 327) data collection time points. Adolescents had at least two out of three sociodemographic risk conditions at enrollment: unmarried, < 12 years of education, or unemployed.

Methods: Simultaneous linear regression was used to regress BMI, BMI change and perception of health for each time point on GWG, age, pre-pregnant BMI, parity, and smoking patterns.

 Results:  GWG, pre-pregnant BMI, parity and smoking predicted BMI and BMI change respectively at years 12 (R² = .57; F= 56.7; p < .001; R² = .17; F = 9.77; p < .001) and 18 (R² = .42; F = 40.8; p < .001: R²= .15; F = 10.27; p < .001) post delivery of a first child. Age was not a predictor of BMI or BMI change. Results by age group (< 16; 16-17; 18-19 years old) indicated variation in strength of predictors for BMI and BMI change at both time points. Gestational weight gain below or above the Institute of Medicine recommendations contributed to BMI 18 years later (p = .036; .027 respectively). Poor health and BMI were associated cross-sectionally and across time when controlling for GWG (p < .001; p < .05, respectively).

Conclusion/Implications for nursing practice: For these at-risk girls, long-term BMI was impacted by GWG, pre-pregnant BMI, and also cigarette smoking and number of additional children in ensuing years. Primiparous black adolescent girls whose GWG is above the IOM recommendations continue to experience weight effects 18 years after delivering their first child, a finding similar to that seen in adult women. Controlling weight prior to pregnancy and limiting GWG to within the IOM recommendations may limit obesity in adulthood in primiparous black adolescents.

Keywords: Pregnancy, gestational weight gain, BMI