Hediger M L, Scholl T O, Schall J I
Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey-SOM, Stratford 08084, USA.
Ann N Y Acad Sci. 1997 May 28;817:281-91. doi: 10.1111/j.1749-6632.1997.tb48214.x.
One of the principal goals of the Camden Study over the past decade has been to document the extent to which pregnancy during adolescence is affected by continued maternal growth. Findings from the Camden Study relating to the other main goal, the effects of maternal growth during pregnancy on the outcome of pregnancy (maternal-fetal competition), are reviewed elsewhere. Contrary to widely held beliefs, we have found that there is considerable growth in late adolescence for girls, and, in particular, continued development of weight (> 1 kg/year) and increases in subcutaneous fatness at central sites. Thus, when pregnancy occurs during this final phase of adolescent growth, the normal growth processes may be exacerbated. That is, the adolescent potential for weight gain (as fat) may be exploited. Along with others, we have documented that adolescent pregnancy is associated with larger gestational weight gains. Using methods sufficiently sensitive to detect maternal growth prospectively, we also found that the larger-than-average total weight gains among adolescents appear attributable primarily to the growing adolescent gravidas and reflect their continued accrual of subcutaneous fat and increased risk for weight retention. Excessive gestational weight gain, as is more common among growing adolescent gravidas, appears to exacerbate the accumulation of fat at central sites. Aside from the consequences to the outcome of pregnancy, adolescents who begin their childbearing early while still growing themselves, such as those we have followed in the Camden Study over the past decade, may be at particularly increased risk for overweight and obesity. Further, the excessive deposition of subcutaneous fat at central body sites, as we have documented for adolescent pregnancy, will often in later life presage the development of cardiovascular disease, noninsulin-dependent diabetes mellitus (NIDDM), and hypertension. Thus, far from being benign, pregnancy during adolescence, particularly when the adolescent is herself still growing, may contribute to long-term risk for obesity-related diseases and diminish the quality of life.
在过去十年里，卡姆登研究的主要目标之一是记录青春期怀孕受母亲持续生长影响的程度。卡姆登研究关于另一个主要目标（孕期母亲生长对妊娠结局的影响，即母胎竞争）的研究结果在其他地方进行了综述。与广泛持有的观点相反，我们发现青春期后期女孩仍有显著生长，尤其是体重持续增加（每年超过1千克），且身体中心部位的皮下脂肪增多。因此，当怀孕发生在青春期生长的最后阶段时，正常的生长过程可能会加剧。也就是说，青春期增加体重（以脂肪形式）的潜力可能会被利用。和其他人一样，我们记录到青少年怀孕与孕期体重增加较多有关。通过使用足够灵敏的方法来前瞻性地检测母亲的生长情况，我们还发现青少年中高于平均水平的总体重增加主要归因于仍在生长的青少年孕妇，这反映了她们皮下脂肪的持续积累以及体重滞留风险的增加。在仍在生长的青少年孕妇中更常见的过度孕期体重增加，似乎会加剧身体中心部位脂肪的堆积。除了对妊娠结局的影响外，那些在自身仍在生长时就早早开始生育的青少年，比如我们在过去十年卡姆登研究中跟踪的那些青少年，超重和肥胖的风险可能会特别增加。此外，正如我们记录的青少年怀孕情况那样，身体中心部位皮下脂肪的过度沉积在以后的生活中往往预示着心血管疾病、非胰岛素依赖型糖尿病（NIDDM）和高血压的发生。因此，青春期怀孕远非无害，尤其是当青少年自身仍在生长时，可能会导致与肥胖相关疾病的长期风险增加，并降低生活质量。
