title: Low maternal vitamin B12 status is associated with intrauterine growth retardation in urban South Indians.
abstract: 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).
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Bangalore City, India.
  
  
  METHODS
  A total of 478 women were recruited at 12.9+/-3.3 weeks of gestation and followed up at the first, second and third trimesters of pregnancy and at delivery. The dropout rate was 8.5%.
  
  
  METHODS
  None.
  
  
  METHODS
  Birth weight was measured at hospital delivery.
  
  
  RESULTS
  The mean birth weight was 2.85+/-0.45 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.
authors.affiliation: Division of Nutrition, Institute of Population Health and Clinical Research, St John's National Academy of Health Sciences, Bangalore, India. sumithra@phcr.res.in
authors.forename: S
authors.initials: S
authors.lastname: Muthayya
authors.forename: A V
authors.initials: AV
authors.lastname: Kurpad
authors.forename: C P
authors.initials: CP
authors.lastname: Duggan
authors.forename: R J
authors.initials: RJ
authors.lastname: Bosch
authors.forename: P
authors.initials: P
authors.lastname: Dwarkanath
authors.forename: A
authors.initials: A
authors.lastname: Mhaskar
authors.forename: R
authors.initials: R
authors.lastname: Mhaskar
authors.forename: A
authors.initials: A
authors.lastname: Thomas
authors.forename: M
authors.initials: M
authors.lastname: Vaz
authors.forename: S
authors.initials: S
authors.lastname: Bhat
authors.forename: W W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D015331:Cohort Studies; D016001:Confidence Intervals; D004522:Educational Status; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007194:India / Q000453:epidemiology; D007230:Infant, Low Birth Weight / Q000097:blood; D007231:Infant, Newborn; D009752:Nutritional Status; D016017:Odds Ratio; D011247:Pregnancy / Q000097:blood*; D011248:Pregnancy Complications / Q000097:blood; D011446:Prospective Studies; D012307:Risk Factors; D014805:Vitamin B 12 / Q000097:blood*; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000150:complications*; D015430:Weight Gain / Q000502:physiology*
chemical_list: D014805:Vitamin B 12