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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica


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1619-3997
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Volume 47, Issue 7

Issues

Association of dietary intake below recommendations and micronutrient deficiencies during pregnancy and low birthweight

Hari Shankar
  • Corresponding author
  • Epidemiology and Clinical Research Division, ICMR – National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India
  • Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
  • Department of Biochemistry, Panjab University, Chandigarh 160014, India
  • Email
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/ Neeta Kumar
  • Department of Reproductive Biology and Maternal Health, Child Health, Indian Council of Medical Research, Ansari Nagar, New Delhi 110029, India
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/ Rajat Sandhir / Mrigendra Pal Singh / Suneeta Mittal
  • Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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/ Tulsi Adhikari / Mohd. Tarique
  • Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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/ Parmeet Kaur
  • Department of Dietetics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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/ M.S. Radhika / Arun Kumar
  • Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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/ D.N. Rao
  • Corresponding author
  • Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
  • Email
  • Other articles by this author:
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Published Online: 2019-07-18 | DOI: https://doi.org/10.1515/jpm-2019-0053

Abstract

Background

Pregnancy is associated with biochemical changes leading to increased nutritional demands for the developing fetus that result in altered micronutrient status. The Indian dietary pattern is highly diversified and the data about dietary intake patterns, blood micronutrient profiles and their relation to low birthweight (LBW) is scarce.

Methods

Healthy pregnant women (HPW) were enrolled and followed-up to their assess dietary intake of nutrients, micronutrient profiles and birthweight using a dietary recall method, serum analysis and infant weight measurements, respectively.

Results

At enrolment, more than 90% of HPW had a dietary intake below the recommended dietary allowance (RDA). A significant change in the dietary intake pattern of energy, protein, fat, vitamin A and vitamin C (P < 0.001) was seen except for iron (Fe) [chi-squared (χ2) = 3.16, P = 0.177]. Zinc (Zn) deficiency, magnesium deficiency (MgDef) and anemia ranged between 54–67%, 18–43% and 33–93% which was aggravated at each follow-up visit (P ≤ 0.05). MgDef was significantly associated with LBW [odds ratio (OR): 4.21; P = 0.01] and the risk exacerbate with the persistence of deficiency along with gestation (OR: 7.34; P = 0.04). Pre-delivery (OR: 0.57; P = 0.04) and postpartum (OR: 0.37; P = 0.05) anemia, and a vitamin A-deficient diet (OR: 3.78; P = 0.04) were significantly associated with LBW. LBW risk was much higher in women consuming a vitamin A-deficient diet throughout gestation compared to vitamin A-sufficient dietary intake (OR: 10.00; P = 0.05).

Conclusion

The studied population had a dietary intake well below the RDA. MgDef, anemia and a vitamin A-deficient diet were found to be associated with an increased likelihood of LBW. Nutrient enrichment strategies should be used to combat prevalent micronutrient deficiencies and LBW.

Keywords: anemia; dietary intake; micronutrients; nutrition; pregnancy; recommended dietary allowance

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About the article

Corresponding authors: Dr. Hari Shankar, Epidemiology and Clinical Research Division, ICMR – National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India; Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India; and Department of Biochemistry, Panjab University, Chandigarh 160014, India, Tel.: +91-9891011776, Fax: +91-11-25307111/77; and Dr. D.N. Rao, Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India, Tel.: +91-9868592706, Fax: +91-11-26588641/63

aCurrent affiliation: Fortis Memorial Research Institute, Gurgaon, Haryana 122001, India.


Received: 2019-02-16

Accepted: 2019-06-03

Published Online: 2019-07-18

Published in Print: 2019-09-25


Funding Source: Indian Council of Medical Research

Award identifier / Grant number: 5/7/165/06-RHN

This study was funded by the Indian Council of Medical Research, New Delhi, India (grant no. 5/7/165/06-RHN, Funder Id: http://dx.doi.org/10.13039/501100001411).


Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Journal of Perinatal Medicine, Volume 47, Issue 7, Pages 724–731, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2019-0053.

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