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Questions about adolescent gestational age and birth weight.

There are objections to the statistical techniques used in and the conclusions of a study of gestational age and birth weight among teens in Rochester New York. The researchers adjusted the primary independent variable gestational weight gain yet they did not adjust birth weight the dependent variable for gestation duration the strongest determinant of birth weight. It appears that the researchers deleted regression coefficients for well-known confounders from the final regression models because the coefficients were insignificant. Deletion is acceptable only if the factors are indeed confounding not if the regression coefficients were not significant. Further it is unlikely that the effect of gestation duration was insignificant. The very low prevalence of 2 complications (toxemia and urinary tract infections) in the overall model indicate that they are not significant confounding variables. The fact that younger teenagers had larger weight gains than the older teenagers and that the 2 sets of teenagers had comparably sized infants does not mean that the younger teenagers transferred more of their weight gain to their infants as the researchers stated. In fact the test they used does not allow for them to conclude that the younger teenagers transferred more of their weight gain to their infants than did the older teenagers. They did not use the standard statistical method to test their hypothesis which tests for differences in the intercepts and slopes between the 2 groups. In a different study using data from 372 pregnant teenagers in Camden New Jersey no difference was found in the effect of adjusted gestational weight gain on birth weight between the younger and older groups and the regressions did not differ in intercept (p = 0.9) or in slope (p = 0.66). Finally low chronological age is a very poor substitute for incomplete growth. It should be combined with gynecological age.