BMJ 2014;348:g3227 doi: 10.1136/bmj.g3227 (Published 14 May 2014)
Page 1 of 1
Letters
LETTERS RATES OF TEENAGE PREGNANCY
Obesity and lower teenage pregnancy rates Anne-Thea McGill research clinician and GP School of Population Health, University of Auckland, Tamaki Campus, Glen Innes, Auckland, New Zealand
It seems heartening that unplanned conception and pregnancy rates in teenagers are decreasing in England,1 New Zealand,2 and the United States.3 However, we should be cautious in thinking that our social programmes and availability of new family planning technologies are the only solutions to this problem.
are associated with increased inflammatory activation and hypertension.5 These are known reasons for failing to achieve conception, and healthy pregnancies for mothers.
The effect of the obesity epidemic on conception is not being considered. Average body mass index of teenagers has increased markedly over the past 20 years. In 2012 obesity rates were just under 20% in the US, and in 2009 New Zealand Maori and Pasifika children’s rates were 20% and 23%, respectively, some of the world’s highest.
Competing interests: None declared.
The authors of the above papers mentioned that many resources and services have been defunded in the past 4-6 years. This could have prompted them to investigate other reasons for the continuing drop in teenage pregnancy rates, especially in impoverished groups, which are often within ethnic minorities.
Obesity has long been associated with decreased rates of conception and poor pregnancy outcomes.4 Central obesity is associated with ectopic fat accumulation and metabolic syndrome, part of which includes polycystic ovary syndrome—a major reason for subfertility. Central obesity related metabolic syndrome is known to be a malnutritive state. Low grade micronutrient insufficiency and lack of food antioxidants for important antioxidant pathways
Enough worrying data exist on the future health of offspring of obese, poorly fed mothers especially those with high concurrent tobacco and alcohol consumption. Although fewer babies may be born to obese mothers, they will be at high risk of obesity, cardiovascular disease, and cancer, and likely mental health and behavioural issues (impulse control) and reduced cognitive potential. Full response at: www.bmj.com/content/348/bmj.g2561/rr/696220. 1 2 3 4 5
Arie S. Has Britain solved its teenage pregnancy problem? BMJ 2014;348:g2561. (14 April.) Johnson A. Striking a better balance: a state of the nation report from the Salvation Army. In: The Salvation Army Social Policy and Parlimentary Unit, editor. Working for the Eradication of Poverty in New Zealand Wellington: Salvation Army, 2014:February. Santelli JS, Lindberg LD, Finer LB, Singh S. Explaining recent declines in adolescent pregnancy in the United States: the contribution of abstinence and improved contraceptive use. Am J Public Health 2007;97:150-6. Kmietowicz Z. Obesity harms a woman’s chances of conception, study shows. BMJ 2013;347:f4418. Dinkova-Kostova AT, Talalay P. Direct and indirect antioxidant properties of inducers of cytoprotective proteins. Mol Nutr Food Res 2008;52:S128-38.
Cite this as: BMJ 2014;348:g3227 © BMJ Publishing Group Ltd 2014
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
Letters
LETTERS RATES OF TEENAGE PREGNANCY
Obesity and lower teenage pregnancy rates Anne-Thea McGill research clinician and GP School of Population Health, University of Auckland, Tamaki Campus, Glen Innes, Auckland, New Zealand
It seems heartening that unplanned conception and pregnancy rates in teenagers are decreasing in England,1 New Zealand,2 and the United States.3 However, we should be cautious in thinking that our social programmes and availability of new family planning technologies are the only solutions to this problem.
are associated with increased inflammatory activation and hypertension.5 These are known reasons for failing to achieve conception, and healthy pregnancies for mothers.
The effect of the obesity epidemic on conception is not being considered. Average body mass index of teenagers has increased markedly over the past 20 years. In 2012 obesity rates were just under 20% in the US, and in 2009 New Zealand Maori and Pasifika children’s rates were 20% and 23%, respectively, some of the world’s highest.
Competing interests: None declared.
The authors of the above papers mentioned that many resources and services have been defunded in the past 4-6 years. This could have prompted them to investigate other reasons for the continuing drop in teenage pregnancy rates, especially in impoverished groups, which are often within ethnic minorities.
Obesity has long been associated with decreased rates of conception and poor pregnancy outcomes.4 Central obesity is associated with ectopic fat accumulation and metabolic syndrome, part of which includes polycystic ovary syndrome—a major reason for subfertility. Central obesity related metabolic syndrome is known to be a malnutritive state. Low grade micronutrient insufficiency and lack of food antioxidants for important antioxidant pathways
Enough worrying data exist on the future health of offspring of obese, poorly fed mothers especially those with high concurrent tobacco and alcohol consumption. Although fewer babies may be born to obese mothers, they will be at high risk of obesity, cardiovascular disease, and cancer, and likely mental health and behavioural issues (impulse control) and reduced cognitive potential. Full response at: www.bmj.com/content/348/bmj.g2561/rr/696220. 1 2 3 4 5
Arie S. Has Britain solved its teenage pregnancy problem? BMJ 2014;348:g2561. (14 April.) Johnson A. Striking a better balance: a state of the nation report from the Salvation Army. In: The Salvation Army Social Policy and Parlimentary Unit, editor. Working for the Eradication of Poverty in New Zealand Wellington: Salvation Army, 2014:February. Santelli JS, Lindberg LD, Finer LB, Singh S. Explaining recent declines in adolescent pregnancy in the United States: the contribution of abstinence and improved contraceptive use. Am J Public Health 2007;97:150-6. Kmietowicz Z. Obesity harms a woman’s chances of conception, study shows. BMJ 2013;347:f4418. Dinkova-Kostova AT, Talalay P. Direct and indirect antioxidant properties of inducers of cytoprotective proteins. Mol Nutr Food Res 2008;52:S128-38.
Cite this as: BMJ 2014;348:g3227 © BMJ Publishing Group Ltd 2014
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
