title: Maternal activity in relation to birth size in rural India. The Pune Maternal Nutrition Study.
abstract: OBJECTIVE
  To describe the relationship of the mother's physical activity to the birth size of her baby in a rural Indian population.
  
  
  METHODS
  : Prospective observational study.
  
  
  METHODS
  Six villages near Pune, Maharashtra, India.
  
  
  METHODS
  : A total of 797 women were studied after excluding abortions and termination of pregnancies (112), foetal anomalies (8), multiple pregnancies (3), incomplete pre-pregnancy anthropometry (14) and pregnancies detected later than 21 weeks of gestation (168).
  
  
  METHODS
  An activity questionnaire was developed after focus group discussions and incorporated community-specific activities. It was validated against an observer-maintained diary. Activity scores were derived using published data on energy costs to weight the contributions of various activities. It was then administered to assess physical activity at 18 (+/-2) and 28 (+/-2) weeks of gestation.
  
  
  METHODS
  Birth outcome, maternal weight gain and neonatal anthropometry.
  
  
  RESULTS
  The activity questionnaire was used to classify women into light, moderate and heavy activity categories. Maternal activity did not influence the incidence of prematurity or stillbirth, or the duration of gestation. It was inversely related to maternal weight gain up to 28 weeks of gestation (P=0.002). Higher maternal activity in early, as well as mid gestation, was associated with lower mean birth weight (P=0.05 and 0.02, respectively ), and smaller neonatal head circumference (P=0.005 and 0.009) and mid-arm circumference (P=0.03 and 0.01) after adjusting for the effect of major confounding factors.
  
  
  CONCLUSIONS
  The Findings suggest that excessive maternal activity during pregnancy is associated with smaller foetal size in rural India, The approach described for developing an activity questionnaire has potential for adoption in other settings.
authors.affiliation: Biometry and Nutrition Unit, Agharkar Research Institute, Pune, India. srao@pn3.vsnl.net.in
authors.forename: S
authors.initials: S
authors.lastname: Rao
authors.forename: A
authors.initials: A
authors.lastname: Kanade
authors.forename: B M
authors.initials: BM
authors.lastname: Margetts
authors.forename: C S
authors.initials: CS
authors.lastname: Yajnik
authors.forename: H
authors.initials: H
authors.lastname: Lubree
authors.forename: S
authors.initials: S
authors.lastname: Rege
authors.forename: B
authors.initials: B
authors.lastname: Desai
authors.forename: A
authors.initials: A
authors.lastname: Jackson
authors.forename: C H D
authors.initials: CH
authors.lastname: Fall
mesh_terms: D001724:Birth Weight; D002508:Cephalometry; D015444:Exercise; D005260:Female; D005865:Gestational Age; D006801:Humans; D007194:India; D007231:Infant, Newborn; D039382:Maternal Nutritional Physiological Phenomena; D009043:Motor Activity; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012424:Rural Population; D011795:Surveys and Questionnaires; D015430:Weight Gain