Nutritional assessment of pregnant adolescents: comparison of two popular classification systems

• Published in: Maternal and child nutrition Vol. 11; no. 3; pp. 305 - 313
• Main Authors: Amaral, Janaina de Fátima Ávila, Vasconcelos, Guilherme Miranda, Torloni, Maria Regina, Fisberg, Mauro, Sampaio, Isa de Pádua Cintra, Guazzelli, Cristina Aparecida Falbo
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.07.2015; John Wiley and Sons Inc
• Subjects: Adolescent; Adult; Age Distribution; Body Mass Index; Body Weight - physiology; Brazil; Centers for Disease Control and Prevention, U.S; classification; Cross-Sectional Studies; Female; Humans; ideal body weight; National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; Nutrition Assessment; Nutritional Status - physiology; Original; Pregnancy; pregnancy in adolescence; Pregnancy in Adolescence - physiology; prenatal nutritional physiological phenomena; Prenatal Nutritional Physiological Phenomena - physiology; United States; Young Adult; Brazil; United States; ideal body weight; pregnancy in adolescence; nutrition assessment; classification; prenatal nutritional physiological phenomena; body mass index
• DOI: 10.1111/mcn.12016
• ISSN: 1740-8695

The objective of this study was to assess the degree of concordance between two popular classification systems [the Centers for Disease Control and Prevention (CDC)‐2000 and the Institute of Medicine (IOM)‐2009] used to categorise the nutritional status of pregnant adolescents. This cross‐sectional study involved 327 pregnant adolescents (10–19 years) booking for antenatal care at a single public maternity in São Paulo, Brazil. Participants were classified into one of four categories, by both systems according to their pre‐pregnancy body mass index and age. The CDC‐2000 system classified significantly fewer pregnant adolescents as underweight (3.7% vs. 12.5%, P < 0.0001) and significantly more adolescents as normal‐weight (86.8% vs. 75.6%, P = 0.0003) than the IOM‐2009 system. The distribution of the adolescents in the two systems differed significantly. The global rate of discordance was 13.5%. The overall concordance between the two systems was marginally good (K = 0.63), being moderate for younger (<16 years) adolescents (K = 0.52). Approximately one in every seven pregnant adolescent would be classified in a non‐corresponding category if the IOM‐2009 classification was used instead of the CDC‐2000 classification. The IOM‐2009 nutritional classification, which does not take into account age and gender, tends to overestimate the proportion of underweight adolescents, especially in the younger‐age group. The use of this classification system can lead to recommendations of higher gestational weight gain in a substantial proportion of pregnant adolescents, which could predispose to post‐partum weight retention and future obesity.