In the 1970s low dietary intake, pre-pregnancy under-nutrition and low weight gain during pregnancy were thought to be the major factors responsible for over 1/3rd of infants being born with low birth weight in India. Over decades there has been improvement in nutritional status of women; currently both maternal under-nutrition and over-nutrition are major public health problems. Despite improvement in maternal nutritional status, there has been no improvement in birth weight. A study was taken up in women from urban low-middle-income families, to assess maternal nutritional status, weight gain during pregnancy and birth weight; in a sub-group of women the magnitude of residual post-pregnancy weight retention was investigated. Urban women from low-middle-income families (1235) attending antenatal clinics in primary health care institution or receiving antenatal care in community settings, were enrolled for this longitudinal observational study. Gestational age and weight were recorded in 1235 women during 4467 antenatal visits. Mean weight gain in 2nd and 3rd trimester was 7.5 kg. Data on birth-weight was available in 853 women; mean birth-weight was 2.7 kg. In 145 women in whom pre- and post-pregnancy weight was available; the post-pregnancy weight retention was 1.9 kg. Women were heavier before and during pregnancy and there has been improvement in pregnancy weight gain as compared to two decades ago but there was no change in mean birth-weight. Screening, identifying under- or over-nourished pregnant women and providing them with appropriate nutrition and health care can enable improvement in maternal nutrition and birth weight.

In India, calcium intake is low and the prevalence of Vitamin D deficiency in pregnant women is high. The National Guidelines envisage elemental calcium 500 mg (as calcium carbonate salt) and 250 IU vitamin D supplements should be provided to pregnant and lactating women. In Delhi, iron folic acid tablets are given twice a day after meals in anaemic women and one tablet of calcium and vitamin D daily after a meal in all pregnant women. A study was taken up to assess the availability and compliance with calcium and vitamin D supplementation in primary health care institutions under research (Group 1 - 387 women) and service conditions (Group 2 - 400 women) and in urban community setting (Group 3 - 448 women). Women in Group 1 received Ca and Vitamin D tablets regularly from the research staff. In Group 2 and Group 3 tablets, were provided as and when government supplies were available and prescriptions were given when they were not available. Ca and Vitamin D tablets were expensive; families bought the tablets as and when they had the funds. As a result, the number of tablets available for consumption was lower in Group 2 and 3. In all three groups, side effects were rare and nearly all available tablets were consumed. In Group 1, Vitamin D estimation was done at enrolment and after supplementation for three months; 83% of women at enrolment and 68% of women after three months of supplementation had serum vitamin D levels below 20 ng/ml. These data suggest that one tablet of Ca and Vit D per day is insufficient for correcting maternal vitamin D deficiency. It is essential to carry out studies to assess the impact of supplementation with two tablets of Ca and Vit D on maternal vitamin D levels.

Background: Leukemia Inhibitory Factor (LIF) plays an essential role in oocyte maturation and during early embryonic development. The present study aims to improve the in vitro cattle embryo production by supplementing culture media with LIF. Methods: Fresh ovaries and oviducts were collected from an abattoir in 0.9% saline (30-35°C) supplemented with antibiotics. Total 542 cumulus-oocyte complexes were aspirated from ovaries and cultured in maturation media in 5% CO2 incubator at 38.5°C with maximum humidity after 5-6 times washing. After 24 h matured oocytes were co-incubated with in vitro capacitated sperms in FBO medium. After 15-18 h cumulus cells were stripped off and presumptive zygotes were cultured in mCR2aa medium. After 40 to 42 h, cleavage was observed and embryos were cultured for 7-9 days. Culture media used to replace with fresh media after every 24 h. LIF was supplemented with 15, 30, 45 ng/ml. Result: Supplementation of LIF in culture media increased maturation rate, cleavage rate significantly (P less than 0.05). LIF Supplementation @ 30 ng/ml during culture increased blastocyst development (in control group 7.0±1.3 and 7.1±1.2, 12.9±0.4, 10.2±1.5 in 15 ng/ml, 30 ng/ml and 45 ng/ml respectively) significantly.

In India prevalence of anaemia and vitamin D deficiency in pregnancy are widespread. National programmes recommend that two tablets of iron and folic acid (IFA) and two tablets of calcium and vitamin D (Ca & Vit D) to be given every day from second trimester till delivery. To minimize the side effects and increase compliance, it is advised that each tablet should be taken after a meal. Most households follow a three meal pattern. A study was taken up to find out how IFA and Ca & Vit D supplementations can be fitted into the habitual three meal pattern. A short term crossover supplementation study was carried out on 38 pregnant women to assess side effects following consumption after lunch of one or two tablets containing 500mg elemental calcium (as calcium carbonate) and 250 IU vitamin D or 60 mg of elemental iron as ferrous sulphate. Prevalence of side effects was higher in women who received iron supplements as compared to Ca & Vit D supplements. Taking two tablets of Ca & Vit D together after meal was associated with significantly higher prevalence of side effects as compared to taking one tablet after meal. Taking two tablets of iron together after meal was not associated with any significant increase in prevalence of side effects as compared to one tablet. Giving two tablets of iron together after one meal and giving one tablet of calcium and vitamin after two meals is feasible option for providing two tablets each of iron and Ca & Vit D to pregnant women who habitually follow a three meal pattern.

In the 1970s poverty leading to low dietary intake prior to and during pregnancy was the major factor responsible for maternal under-nutrition and low birth weight. Over the last four decades there has been reduction in poverty and household food insecurity; concurrently there has been a steep decline in physical activity and some decline in energy intake. As a result of all these changes currently both under-nutrition and over-nutrition are major public health problems in women. A study was undertaken to assess food security status of the family and dietary intake of pregnant women from urban low income families using 24 hour dietary recall. Dietary intakes of pregnant women were compared with intakes of Non-Pregnant Non-Lactating women (NPNL) from the same family. Dietary intakes of both NPNL and pregnant women were compared with Estimated Average Requirement (EAR). Computation of energy intake/CU/day from the diet survey showed that these families were food secure. Both in NPNL and in pregnant women, intakes of cereal and roots and tubers were adequate; pulse, leafy vegetables and other vegetables and milk consumption was below EAR; fat consumption was above EAR. Mean energy intake was higher than EAR in NPNL women. There was a small increase in energy intake during pregnancy and intakes met EAR in pregnant women. Dietary intake of iron was below EAR in pregnant women. In urban sedentary women from food secure families, a small but sustained higher than EAR energy intake over years appears to contribute to progressive increase in over-nutrition with increasing age.