Teenage pregnancy presents biological, social, and cultural challenges to young women as they strive to cope with the physiological and emotional demands of adolescent issues, fetal growth, and impending motherhood. There is considerable evidence worldwide that teenage pregnancy is associated with increased maternal and fetal risk. A range of biological factors has been associated with unfortunate pregnancy outcomes, including poor nutritional status, low pre-pregnancy weight, maternal height, parity, and poor weight gain during pregnancy. Adolescent pregnancy is associated with increased risk for preterm birth and growth-restricted infants. The nutritional needs of pregnant adolescents are the greatest at a time when it is often socially and culturally most difficult to achieve them. Dieting, skipping meals, snacking, eating away from home, consuming fast foods, and trying unconventional diets are challenges to achieving the nutrient dense diet required to optimize growth and development in the mother and child.