Adverse reproductive outcomes and young maternal age

To the Editor: Fraser et al. (April 27 issue)¹ contend that the higher risk for low birth weight and premature birth associated with young maternal age may reflect an underlying inherent biologic risk. However, the contribution of environmental factors, not accounted for in their analysis, may not have been fully appreciated. For example, nutritional factors have a significant influence on birth weight.² Adolescent women not only tend to be underweight but are also very conscious of their body image and tend to gain less weight during pregnancy than older women.² This may be especially true for well-educated women from economically.