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Objective: To assess the maternal sociodemographic, anthropometric, dietary and micronutrient status in apparently healthy pregnant women in order to determine their associations with intrauterine growth retardation (IUGR). Design: Prospective observational study. Setting: Bangalore City, India. Subjects: A total of 478 women were recruited at 12.973.3 weeks of gestation and followed up at the first, second and third trimesters of pregnancy and at delivery. The dropout rate was 8.5%. Interventions: None. Main outcome measures: Birth weight was measured at hospital delivery. Results: The mean birth weight was 2.8570.45 kg. In all, 28.6% of newborns were IUGR. There was a strong inverse relationship between maternal educational level and risk of IUGR. A low body weight at baseline was also associated with a high risk of IUGR. Compared with women in the highest quartile for second trimester weight gain, those in the lowest quartile had a significantly higher adjusted odds ratio (AOR: 3.98; 95% CI: 1.83, 8.65) for IUGR. Women in the lowest tertile for serum vitamin B 12 concentration during each of the three trimesters of pregnancy had significantly higher risk of IUGR (AOR: 5.98, 9.28 and 2.81 for trimesters 1-3, respectively). Conclusions: The present study demonstrates associations between educational status, maternal weight and gestational weight gain with IUGR. Importantly, in a subsample, there were strong associations of vitamin B 12 status with IUGR, suggesting that better socioeconomic conditions, improved nutritional status and early detection of vitamin B 12 deficiency in pregnancy combined with appropriate interventions are likely to play an important role in reducing IUGR.

Background: Inadequate consumption of fish could be a risk factor for low birth weight (LBW). This study assessed fish intake and o-3 LCPUFA intake and status for their association with LBW in a cohort of urban, south Indian pregnant women. Subjects/methods: In a prospective cohort study, data on maternal fish intake and o-3 LCPUFA intake and status of 676 women were obtained at baseline (first trimester), the second and third trimesters of pregnancy. Infant birth weight was measured immediately following hospital delivery. The dropout rate was 7.6%. Results: Fifty-six percent of the study women consumed fish with low daily median intakes (3.4, 4.1 and 3.8 g day À1 at the three trimesters, respectively). Consequently, the median intakes of EPA and DHA during pregnancy were also low at 2.1 and 10.1 mg day À1 , respectively. EPA and DHA intakes were associated with their status in erythrocyte membrane phospholipids during pregnancy (r ¼ 0.40 and 0.36, r ¼ 0.34 and 0.32 and r ¼ 0.37 and 0.41, at the three trimesters, respectively, all Po0.001). Women who did not eat fish during the third trimester had a significantly higher risk of LBW (OR: 2.49, P ¼ 0.019). Similarly, low EPA intake during the third trimester had an association with a higher risk of LBW (OR: 2.75, P ¼ 0.011). Conclusions: Among low fish-eating pregnant women, fish intake in the third trimester was closely associated with birth weight. Supplementation with o-3 LCPUFA during pregnancy may have important implications for fetal development in India.

Objectives: To assess the consequences on body composition of increasing birth weight in Indian babies in relation to reported values in Western babies, and to assess the relationship between maternal and neonatal anthropometry and body composition. Design: Prospective observational study. Setting: Bangalore City, India. Subjects: A total of 712 women were recruited at 12.5^3.1 weeks of gestation (mean^standard deviation, SD) and followed up until delivery; 14.5% were lost to follow-up. Maternal body weight, height, mid upper-arm circumference and skinfold thicknesses were measured at recruitment. Weight and body composition of the baby (skinfold thicknesses, mid upper-arm circumference, derived arm fat index and arm muscle index; AFI and AMI, respectively) were measured at birth in hospital. Results: The mean^SD birth weight of all newborns was 2.80^0.44 kg. Birth weight was significantly related to the triceps and subscapular skinfold thickness of the baby. In a small number of babies with large birth weight for gestational age, there was a relatively higher normalised AFI relative to AMI than for babies with lower or appropriate birth weight for gestational age. Maternal height and fat-free mass were significantly associated with the baby's length at birth. Conclusions: Skinfold thicknesses in Indian babies were similar to those reported in a Western population with comparable birth weights, and the relationship of AFI to birth weight appeared to be steeper in Indian babies. Thus, measures to increase birth weight in Indian babies should take into account possible adverse consequences on body composition. There were no significant relationships between maternal anthropometry and body composition at birth on multivariate analysis, except for sum of the baby's skinfold thicknesses and maternal fat-free mass (P , 0.02).