The proposed research is a controlled, prospective study of U.S. adolescents exposed to pregnancy at an age when linear growth occurs. A total of 225 young primigravid adolescents (15 years or younger), 225 multigravid adolescents (currently 18 years or younger) with a first pregnancy at 15 or less and 450 multigravid and primigravid women, with age at first pregnancy of 18 or greater, will be enrolled during pregnancy and followed through delivery to 24 weeks postpartum. Subjects are matched by ethnicity and clinic payment status and stratified by age at first pregnancy and current gravidity. The research will characterize nutritional status during pregnancy and the postpartum (measured by anthropometry, dietary intakes and biochemical determination of zinc, folate, calcium and iron), determine if growth is associated with poorer nutritional status and determine if poorer nutritional status is associated with increased pregnancy complications (PIH) and poor pregnancy outcomes (pre-term delivery and low birthweight). Multigravid adolescents, with first pregnancy at an age when growth occurs, are included to study effects of early adolescent pregnancy on nutritional status and pregnancy outcomes in a subsequent adolescent pregnancy. Mature controls, unexposed to pregnancy during growth, are included for comparison. There are three principal hypotheses: (1) that linear growth during pregnancy and postpartum is associated with poorer nutritional status; (2) that poorer nutritional status in adolescents increases their risk of complications (PIH) and preterm delivery/low birthweight; and (3) that pregnancy risk factors with a nutritional component increase from one pregnancy to the next and increase risk of preterm delivery/low birthweight in subsequent pregnancies of multigravid adolescents.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
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Epidemiology and Disease Control Subcommittee 3 (EDC)
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University of Medicine & Dentistry of NJ
Schools of Osteopathy
United States
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Chen, Xinhua; Scholl, Theresa O (2014) Maternal biomarkers of endothelial dysfunction and preterm delivery. PLoS One 9:e85716
Scholl, Theresa O; Chen, Xinhua; Goldberg, Gary S et al. (2011) Maternal diet, C-reactive protein, and the outcome of pregnancy. J Am Coll Nutr 30:233-40
Chen, Xinhua; Scholl, Theresa O; Leskiw, Maria et al. (2010) Differences in maternal circulating fatty acid composition and dietary fat intake in women with gestational diabetes mellitus or mild gestational hyperglycemia. Diabetes Care 33:2049-54
Chen, Xinhua; Scholl, Theresa O (2008) Association of elevated free fatty acids during late pregnancy with preterm delivery. Obstet Gynecol 112:297-303
Chen, Xinhua; Scholl, Theresa O; Stein, T Peter (2006) Association of elevated serum ferritin levels and the risk of gestational diabetes mellitus in pregnant women: The Camden study. Diabetes Care 29:1077-82
Scholl, Theresa O (2005) Iron status during pregnancy: setting the stage for mother and infant. Am J Clin Nutr 81:1218S-1222S
Stagnaro-Green, Alex; Chen, Xinhua; Bogden, John D et al. (2005) The thyroid and pregnancy: a novel risk factor for very preterm delivery. Thyroid 15:351-7
Johnson, William G; Scholl, Theresa O; Spychala, John R et al. (2005) Common dihydrofolate reductase 19-base pair deletion allele: a novel risk factor for preterm delivery. Am J Clin Nutr 81:664-8
Chen, Xinhua; Scholl, Theresa O (2005) Oxidative stress: changes in pregnancy and with gestational diabetes mellitus. Curr Diab Rep 5:282-8
Scholl, Theresa O; Chen, Xinhua; Khoo, Chor San et al. (2004) The dietary glycemic index during pregnancy: influence on infant birth weight, fetal growth, and biomarkers of carbohydrate metabolism. Am J Epidemiol 159:467-74

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