Original Article
European Journal of Clinical Nutrition (2006) 60, 791–801. doi:10.1038/sj.ejcn.1602383; published online 11 January 2006
Low maternal vitamin B12 status is associated with intrauterine growth retardation in urban South Indians
Guarantor: S Muthayya.
Contributors: SM was involved in study design and implementation, data analysis and writing of the manuscript. AVK was involved in study design, data analysis and writing of the manuscript. CPD, RJB and WWF provided expert advice on data analysis and write-up. PD was involved in study design, implementation and data entry. MV was involved in study design and write-up. AM, RM, AT and SB provided study subjects and facilities for this collaborative research. The authors have no conflicts of interest.
S Muthayya1, A V Kurpad1, C P Duggan2, R J Bosch3, P Dwarkanath1, A Mhaskar4, R Mhaskar4, A Thomas4, M Vaz1, S Bhat5 and W W Fawzi2
- 1Division of Nutrition, Institute of Population Health and Clinical Research, St John's National Academy of Health Sciences, Bangalore, India
- 2Department of Nutrition, Harvard School of Public Health, Huntington Avenue, Boston, MA, USA
- 3Department of Biostatistics, Harvard School of Public Health, Huntington Avenue, Boston, MA, USA
- 4Department of Obstetrics and Gynecology, St John's Medical College Hospital, Bangalore, India
- 5Department of Pediatrics, St John's Medical College Hospital, Bangalore, India
Correspondence: Dr S Muthayya, Division of Nutrition, Institute of Population Health and Clinical Research, St John's National Academy of Health Sciences, Bangalore, Karnataka 560 034, India. E-mail: sumithra@iphcr.res.in
Received 16 June 2005; Revised 7 November 2005; Accepted 15 November 2005; Published online 11 January 2006.
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).
Design:
Prospective observational study.
Setting:
Bangalore City, India.
Subjects:
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%.
Interventions:
None.
Main outcome measures:
Birth weight was measured at hospital delivery.
Results:
The mean birth weight was 2.850.45 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 B12 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 B12 status with IUGR, suggesting that better socioeconomic conditions, improved nutritional status and early detection of vitamin B12 deficiency in pregnancy combined with appropriate interventions are likely to play an important role in reducing IUGR.
Sponsorship:
This research was partly supported by the GlaxoSmithKline Consumer Healthcare Ltd, India.
Keywords:
intrauterine growth retardation, pregnancy, vitamin B12, education
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