Intake of micronutrient-rich foods in rural Indian mothers is associated with the size of their babies at birth: Pune maternal nutrition study

One third of the Indian babies are of low birth weight (<2.5 kg), and this is attributed to maternal undernutrition. We therefore examined the relatio nship between maternal nutrition and birth size in a prospective study of 7 97 rural Indian women, focusing on macronutrient intakes, dietary quality a nd micronutrient status. Maternal intakes (24-h recall and food frequency q uestionnaire) and erythrocyte folate, serum ferritin and vitamin C concentr ations were measured at 18 <plus/minus> 2 and 28 +/- 2 wk gestation. Mother s were short (151.9 +/- 5.1 cm) and underweight (41.7 +/- 5.1 kg) and had l ow energy and protein intakes at 18 wk (7.4 +/- 2.1 MJ and 45.4 +/- 14.1 g) and 28 wk (7.0 +/- 2.0 MJ and 43.5 +/- 13.5 g) of gestation. Mean birth we ight and length of term babies were also low (2665 +/- 358 g and 47.8 +/- 2 .0 cm, respectively). Energy and protein intakes were not associated with b irth size, but higher fat intake at wk 18 was associated with neonatal leng th (P < 0.001), birth weight (P < 0.05) and triceps skinfold thickness (P < 0.05) when adjusted for sex, parity and gestation. However, birth size was strongly associated with the consumption of milk at wk 18 (P < 0.05) and o f green leafy vegetables (P < 0.001) and fruits (P < 0.01) at wk 28 of gest ation even after adjustment for potentially confounding variables. Erythroc yte folate at 28 wk gestation was positively associated with birth weight ( P < 0.001). The lack of association between size at birth and maternal ener gy and protein intake but strong associations with folate status and with i ntakes of foods rich in micronutrients suggest that micronutrients may be i mportant limiting factors for fetal growth in this undernourished community .