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We demonstrate an optical magnetometer based on a microfabricated 87Rb vapor cell in a micromachined silicon sensor head. The alkali atom density in the vapor cell is increased by heating the cell with light brought to the sensor through an optical fiber, and absorbed by colored filters attached to the cell windows. A second fiber-optically coupled beam optically pumps and interrogates the atoms. The magnetometer operates on 140 mW of heating power and achieves a sensitivity below 20 fT/[Square_Root]Hz throughout most of the frequency band from 15 Hz to 100 Hz. Such a sensor can measure magnetic fields from the human heart and brain. [ABSTRACT FROM AUTHOR]

A method of imaging distributions of cold atoms under the presence of large trapping-field-induced level shifts is investigated. By utilizing a probe laser tuned to an open transition, the fluorescence yield per atom is largely fixed throughout the trap volume, independent of the trapping field. This enables a reliable conversion of fluorescence images into atomic-density profiles. The method is applied to measure distributions of 87Rb atoms in a high-gradient (2.7 kG/cm) magnetic atom guide. We characterize the parameters for which the open-channel imaging method performs best. Results of quantum Monte Carlo simulations verify the underlying assumptions of the method. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the use of amniotic membrane grafts in cases of vaginal and cervical agenesis.Methods: Five girls with complete cervical and vaginal agenesis underwent cervicoplasty and vaginoplasty using amniotic membrane grafts.Result: Excellent epithelization and patency of cervix and vagina was achieved in all cases.Conclusion: Amniotic membrane may be used as an allograft in cervical reconstruction. It is inexpensive, readily available, of low antigenicity and does not necessitate repeated cervical dilatation. The performance of the reconstructed cervix during labor is yet to be observed. To the author's knowledge, this is the first series reported in the literature in which amniotic membrane was used for cervical reconstruction. [ABSTRACT FROM AUTHOR]

The standard of care trimodality therapy for resectable locally advanced esophageal adenocarcinoma is complex and necessitates multidisciplinary care and expertise. In this work, it is hypothesized that facility clinical volume and utilization of intensity-modulated radiotherapy (IMRT) may influence outcomes. The National Cancer Data Base was queried for patients with cT1-4-N0-3 M0 esophageal adenocarcinoma undergoing trimodality therapy from 2004 to 2013 (n  = 2445). All patients received chemoradiation followed by esophagectomy at a Commission on Cancer facility. The facility volume was categorized into tertiles: high-volume centers (HVCs) in the highest 25th percentile of cases per year, intermediate-volume centers (IVCs) with the next highest 25th percentile of cases, and low- and very low-volume centers (LVCs) in the lowest 50th percentile. Overall survival (OS) was estimated using Kaplan–Meier methods and Cox proportional hazard regression. Propensity score matching to balance patient characteristics between volume centers was performed. Subgroup analysis was done comparing IMRT versus 3D conformal radiotherapy. The median follow-up was 26 months. Treatment at an HVC (hazard ratio 0.63, 95% CI 0.49–0.81, P  < 0.001) was found to be independently associated with improved overall survival in multivariable analysis. Three-year OS was 58.4%, 46.2%, and 47.5% for HVCs, IVCs, and LVCs, respectively (P  < 0.001). Patients at HVCs were more likely to receive IMRT over 3D chemoradiation (CRT; OR 3.45, 95% CI 2.4–5.0, P  < 0.001). Patients treated using IMRT at HVCs had improved OS compared to those treated at IVCs or LVCs (HR 0.68, 95% CI 0.52–0.90, P  < 0.01), while patients treated with 3D CRT at HVCs had no survival advantage over those at IVCs or LVCs (P  = 0.28). Patients with locally advanced esophageal adenocarcinoma treated with IMRT and at HVCs appear to have improved survival. [ABSTRACT FROM AUTHOR]

Methylene blue administered through cervix is used to check tubal patency at laparoscopy. Although methylene blue is used to treat methemoglobinemia it can also produce methemoglobinemia in susceptible individuals. A case of methemoglobinemia induced by methylene blue in a patient with treated pelvic tuberculosis is presented. [Copyright &y& Elsevier]

The article presents a case study of a 19-year-old girl with a malignant peripheral nerve sheath tumour (MPNST) of the vagina. Diagnostic laparoscopy revealed a normal uterus, ovaries and a necrotic friable mass distending the vagina to three times its size. Chemotherapy was planned but the girl refused further treatment.

Despite improvements in healthcare for uninsured persons, health disparities remain. We surveyed patients at three free clinics in an urban Florida community to better understand the factors that influence where they seek healthcare. Survey questions were developed based on factors previously demonstrated to affect healthcare utilization. A focus group validated the instrument. Patients self-administered written surveys over a 6-week period at three free clinics, including a student-run free clinic (SRFC). Results were compiled and analyzed using Chi-square and Fisher–Freeman–Halton Exact tests, Kruskal–Wallis test, Mann–Whitney U test, and Spearman's rho, as appropriate. Odds ratios were calculated for significant findings (p < 0.05). Patients completed 323 surveys. Free clinic visit frequency was positively related to female gender, Hispanic ethnicity, higher income, and poorer health. Black race was related to less frequent visits. Visit frequency differed among the clinic sites. Patients attending a SRFC were more likely to utilize another clinic. Patient satisfaction was not related to visit frequency. Seeking care at other clinics was related to employment. Emergency room utilization was positively related to male gender. Patients listed proximity and ability to receive care not offered at the free clinic as the primary reasons for seeking care at another clinic. In this sample, free clinic utilization was related to demographic and community factors. Free clinics should consider these factors when designing their care delivery. SRFC's should further evaluate how they function in the safety net. [ABSTRACT FROM AUTHOR]

Abstract: Objective: While previous studies have shown the potential effects of yoga in normal pregnancies, this randomized controlled trial investigated the effects of yoga in prevention of pregnancy complications in high-risk pregnancies for the first time. Methods: 68 high-risk pregnant women were recruited from two maternity hospitals in Bengaluru, India and were randomized into yoga and control groups. The yoga group (n=30) received standard care plus one-hour yoga sessions, three times a week, from the 12th to the 28th week of gestation. The control group (n=38) received standard care plus conventional antenatal exercises (walking) during the same period. Results: Significantly fewer pregnancy induced hypertension (PIH), preeclampsia, gestational diabetes (GDM) and intrauterine growth restriction (IUGR) cases were observed in the yoga group (p=0.018, 0.042, 0.049, 0.05 respectively). Significantly fewer Small for Gestational Age (SGA) babies and newborns with low APGAR scores (p=0.006) were born in the yoga group (p=0.033). Conclusion: This first randomized study of yoga in high-risk pregnancy has shown that yoga can potentially be an effective therapy in reducing hypertensive related complications of pregnancy and improving fetal outcomes. Additional data is needed to confirm these results and better explain the mechanism of action of yoga in this important area. [Copyright &y& Elsevier]

Objectives: To assess the consequences on body composition of increasing birth weight in Indian babies in relation to reported values in Western babies, and to assess the relationship between maternal and neonatal anthropometry and body composition.Design: Prospective observational study.Setting: Bangalore City, India.Subjects: A total of 712 women were recruited at 12.5+/-3.1 weeks of gestation (mean+/-standard deviation, SD) and followed up until delivery; 14.5% were lost to follow-up. Maternal body weight, height, mid upper-arm circumference and skinfold thicknesses were measured at recruitment. Weight and body composition of the baby (skinfold thicknesses, mid upper-arm circumference, derived arm fat index and arm muscle index; AFI and AMI, respectively) were measured at birth in hospital.Results: The mean+/-SD birth weight of all newborns was 2.80+/-0.44 kg. Birth weight was significantly related to the triceps and subscapular skinfold thickness of the baby. In a small number of babies with large birth weight for gestational age, there was a relatively higher normalised AFI relative to AMI than for babies with lower or appropriate birth weight for gestational age. Maternal height and fat-free mass were significantly associated with the baby's length at birth.Conclusions: Skinfold thicknesses in Indian babies were similar to those reported in a Western population with comparable birth weights, and the relationship of AFI to birth weight appeared to be steeper in Indian babies. Thus, measures to increase birth weight in Indian babies should take into account possible adverse consequences on body composition. There were no significant relationships between maternal anthropometry and body composition at birth on multivariate analysis, except for sum of the baby's skinfold thicknesses and maternal fat-free mass (P<0.02). [ABSTRACT FROM AUTHOR]

The use of left ventricular assist device (LVAD) has increased significantly over the past several years. The physiologic effects of LVAD implantation on pulmonary function are not well elucidated. Studies evaluating the effects of LVAD implantation on pulmonary function testing (PFT) are inconsistent and data regarding the prognostic implications of PFT data on survival are scarce. Our study aims to evaluate the changes of PFT data after LVAD implantation in our own patient population and to assess the impact of pre-operative PFT data in regards to patient survival. This was a single-center, retrospective analysis. Electronic medical records of all patients who underwent LVAD implantation at our institution between October 2011 to December 2019 were reviewed. PFTs prior to implantation were reviewed and were compared to records at 3 months and 12 months, when available. A change in a PFT value of greater than 10% was considered significant. Kaplan-Meier analysis and multivariable Cox regressions were performed to evaluate mortality. A total of 318 patients who underwent LVAD implantation at our center were reviewed. 44 patients who underwent pump exchanges were excluded. 81% of the patients were male and the mean age was 60 years old ± 12 years with a range of 24-83 years. Overall, there were no significant changes in FEV1 or FVC after LVAD implantation, with a mean increase of 2% and 4% in FEV1 at 3 months and 12 months respectively and a mean increase of 6% at both 3 months and 12 months in FVC. On the other hand, DLCO worsened at 3 months and 12 months and decreased by 21% and 10% respectively. A pre-operative DLCO of < 30% was associated with worsened overall mortality (p=0.016). Pulmonary physiology following LVAD implantation is complex. While patients with heart failure historically report improvement in dyspnea and exercise tolerance following their implant, our study indicates that a majority of their PFT values either remain unchanged or even worsen. Our analysis demonstrates a decrease in DLCO after LVAD implantation, which may be related to changes in pulmonary pressures following implantation. A pre-operative DLCO of < 30% carried a significant risk of overall mortality and this should be considered in future pre-operative planning. Further prospective studies are needed for clarification. [ABSTRACT FROM AUTHOR]

Purpose: Use of biologic or synthetic mesh in hernia repair shifts is based on evolving evidence. Poly-4-hydroxybutyrate (P4HB) biosynthetic mesh is a potential alternative to biologic and synthetic mesh in ventral hernia repair (VHR). This meta-analysis assesses the efficacy of P4HB mesh in clean and contaminated surgical settings.Two authors searched literature on PubMed, reviewing titles and abstracts of all articles to determine inclusion eligibility. Post-operative data were compared via transformation method to convert the proportion of patients with the outcome of interest into a suitable quantity for random-effects synthesis using STATA software.Initial search yielded 287 citations. Six studies were included and categorized on whether hernia repairs were conducted in clean (CDC class I) or contaminated cases (CDC class II–IV). The pooled proportion of surgical site infection (SSI), surgical site occurrence (SSO), hernia recurrence, total surgical complications, and reoperation were calculated in 391 clean and 81 contaminated cases. For clean vs. contaminated cases, the following pooled proportions were noted: SSI (2% (CI 0–7%) vs 9% (CI 0–025) (p = 0.03), SSO: 14% (CI 5–25%) vs 35% (CI 22–50%) (p = 0.006), hernia recurrence (8% (CI 1–19%) vs 4% (CI 0–12%) (p = 0.769); surgical complications (17% (CI 6–32%) vs 50% (CI 27–72%) (p = 0.009). Reoperation data were available in 298 clean cases across four studies: 5% (CI 0–15%).P4HB biosynthetic mesh may be more effective than previously thought, particularly in clean wounds. P4HB may also be superior to biologic mesh when compared to clinical trial data. Further research is necessary for more direct comparison.Methods: Use of biologic or synthetic mesh in hernia repair shifts is based on evolving evidence. Poly-4-hydroxybutyrate (P4HB) biosynthetic mesh is a potential alternative to biologic and synthetic mesh in ventral hernia repair (VHR). This meta-analysis assesses the efficacy of P4HB mesh in clean and contaminated surgical settings.Two authors searched literature on PubMed, reviewing titles and abstracts of all articles to determine inclusion eligibility. Post-operative data were compared via transformation method to convert the proportion of patients with the outcome of interest into a suitable quantity for random-effects synthesis using STATA software.Initial search yielded 287 citations. Six studies were included and categorized on whether hernia repairs were conducted in clean (CDC class I) or contaminated cases (CDC class II–IV). The pooled proportion of surgical site infection (SSI), surgical site occurrence (SSO), hernia recurrence, total surgical complications, and reoperation were calculated in 391 clean and 81 contaminated cases. For clean vs. contaminated cases, the following pooled proportions were noted: SSI (2% (CI 0–7%) vs 9% (CI 0–025) (p = 0.03), SSO: 14% (CI 5–25%) vs 35% (CI 22–50%) (p = 0.006), hernia recurrence (8% (CI 1–19%) vs 4% (CI 0–12%) (p = 0.769); surgical complications (17% (CI 6–32%) vs 50% (CI 27–72%) (p = 0.009). Reoperation data were available in 298 clean cases across four studies: 5% (CI 0–15%).P4HB biosynthetic mesh may be more effective than previously thought, particularly in clean wounds. P4HB may also be superior to biologic mesh when compared to clinical trial data. Further research is necessary for more direct comparison.Results: Use of biologic or synthetic mesh in hernia repair shifts is based on evolving evidence. Poly-4-hydroxybutyrate (P4HB) biosynthetic mesh is a potential alternative to biologic and synthetic mesh in ventral hernia repair (VHR). This meta-analysis assesses the efficacy of P4HB mesh in clean and contaminated surgical settings.Two authors searched literature on PubMed, reviewing titles and abstracts of all articles to determine inclusion eligibility. Post-operative data were compared via transformation method to convert the proportion of patients with the outcome of interest into a suitable quantity for random-effects synthesis using STATA software.Initial search yielded 287 citations. Six studies were included and categorized on whether hernia repairs were conducted in clean (CDC class I) or contaminated cases (CDC class II–IV). The pooled proportion of surgical site infection (SSI), surgical site occurrence (SSO), hernia recurrence, total surgical complications, and reoperation were calculated in 391 clean and 81 contaminated cases. For clean vs. contaminated cases, the following pooled proportions were noted: SSI (2% (CI 0–7%) vs 9% (CI 0–025) (p = 0.03), SSO: 14% (CI 5–25%) vs 35% (CI 22–50%) (p = 0.006), hernia recurrence (8% (CI 1–19%) vs 4% (CI 0–12%) (p = 0.769); surgical complications (17% (CI 6–32%) vs 50% (CI 27–72%) (p = 0.009). Reoperation data were available in 298 clean cases across four studies: 5% (CI 0–15%).P4HB biosynthetic mesh may be more effective than previously thought, particularly in clean wounds. P4HB may also be superior to biologic mesh when compared to clinical trial data. Further research is necessary for more direct comparison.Conclusions: Use of biologic or synthetic mesh in hernia repair shifts is based on evolving evidence. Poly-4-hydroxybutyrate (P4HB) biosynthetic mesh is a potential alternative to biologic and synthetic mesh in ventral hernia repair (VHR). This meta-analysis assesses the efficacy of P4HB mesh in clean and contaminated surgical settings.Two authors searched literature on PubMed, reviewing titles and abstracts of all articles to determine inclusion eligibility. Post-operative data were compared via transformation method to convert the proportion of patients with the outcome of interest into a suitable quantity for random-effects synthesis using STATA software.Initial search yielded 287 citations. Six studies were included and categorized on whether hernia repairs were conducted in clean (CDC class I) or contaminated cases (CDC class II–IV). The pooled proportion of surgical site infection (SSI), surgical site occurrence (SSO), hernia recurrence, total surgical complications, and reoperation were calculated in 391 clean and 81 contaminated cases. For clean vs. contaminated cases, the following pooled proportions were noted: SSI (2% (CI 0–7%) vs 9% (CI 0–025) (p = 0.03), SSO: 14% (CI 5–25%) vs 35% (CI 22–50%) (p = 0.006), hernia recurrence (8% (CI 1–19%) vs 4% (CI 0–12%) (p = 0.769); surgical complications (17% (CI 6–32%) vs 50% (CI 27–72%) (p = 0.009). Reoperation data were available in 298 clean cases across four studies: 5% (CI 0–15%).P4HB biosynthetic mesh may be more effective than previously thought, particularly in clean wounds. P4HB may also be superior to biologic mesh when compared to clinical trial data. Further research is necessary for more direct comparison. [ABSTRACT FROM AUTHOR]

Cardiac allograft rejection is a significant concern amongst individuals who have undergone orthotopic heart transplantation. Currently, surveillance is performed through routine endomyocardial biopsy (EMB). While relatively safe in experienced hands, the invasive nature of the procedure lends itself to occasional complications. Several non-invasive techniques for evaluation of cardiac allograft rejection have been evaluated. In this study, we aim to compare the efficacy of two non-invasive methods of detecting rejection against the gold standard of EMB; gene expression profiling with AlloMap and echocardiographic doppler tissue imaging (DTI). This was a single-center, retrospective analysis. Electronic medical records of all patients who underwent orthotopic heart transplant at our institution and had at least two concomitant measurements of AlloMap, echocardiogram DTI and endomyocardial biopsy from January 1st, 2015 to December 31st, 2017 were reviewed. Statistical analyses were performed to calculate sensitivity, specificity, negative predictive value (NPV) and positive predictive value. Rejection for EMB was defined using ISHLT guidelines and was considered present with either acute cellular rejection of 1R or greater or antibody mediated rejection pAMR1 or greater. For non-invasive studies, we considered an AlloMap score of > 34 and a DTI <0.016 m/sec as rejection. A total of 107 patients with available data were reviewed. 77% were male. Mean age was 57 years old ± 13 years with a range of 22-77 years. AlloMap and DTI performed similarly in our cohort and had NPV of 92% and 88%, respectively when compared to similarly timed EMB. Positive predictive value was 9% for AlloMap and 8% for DTI. Sensitivity was 37% for AlloMap and 18% for DTI and specificity was 65% for AlloMap and 74% for DTI. In our cohort, AlloMap and DTI performed similarly and demonstrated excellent NPV in ruling out rejection. AlloMap has known excellent NPV and has been well-validated for this purpose. The NPV of DTI has been less studied, but performed similarly and is highly cost effective. This could have implications on future screening protocols. This study is limited by the inherent errors of a single-center, retrospective analysis. Further prospective studies to validate this data are ongoing. [ABSTRACT FROM AUTHOR]

Graft-versus-host-disease (GVHD) is a major complication associated with allogeneic hematopoietic cell transplantation (allo-HCT). Antithymocyte globulin (ATG) is recommended for GVHD prophylaxis following allo-HCT, however, evidence on efficacy of ATG is conflicting. Accordingly, we undertook a systematic review. All phase III randomized controlled trials (RCTs) comparing ATG versus control for prevention of GVHD in patients undergoing allo-HCT were eligible. Medline and Cochrane databases were searched. Data on methodological quality, benefits and harms were extracted for each trial and pooled under a random effects model. Seven RCTs enrolling 733 patients met inclusion criteria. Pooled results showed no difference for overall survival with use of ATG (hazard ratio was 0.91; 95% confidence intervals (CI), 0.75-1.10; P=0.32). There was a significant benefit for prevention of grade III/IV acute GVHD (risk ratio (RR)=0.51; 95% CI, 0.27-0.94; P=0.03). There was no benefit associated with ATG use for prevention of either grade II (RR=0.79; 95% CI, 0.48-1.30; P=0.35) or grade I acute GVHD (RR=1.42; 95% CI, 0.75-2.69; P=0.28). Use of ATG was not associated with significant reduction in non-relapse mortality (RR=0.74; 95% CI, 0.53-1.03; P=0.08). Future trials with adequate sample size are required to provide more definitive answers. [ABSTRACT FROM AUTHOR]

We study a photoionization method to detect and image a narrow beam of cold atoms traveling along a high-gradient two-wire magnetic guide that is continuously on. Ions are accelerated in a compact acceleration region, directed through a drift region several centimeters in length, and detected using a position-sensitive ion detector. The potentials of several electrodes can be varied to adjust the imaging properties. Using ion trajectory simulations as well as experiments, we study the passage of the ions through the detection system, the magnification of the detection system, and the time-of-flight characteristics. [ABSTRACT FROM AUTHOR]

Background/Objectives:Fetal energy demands are met from the oxidation of maternally supplied glucose and amino acids. During the fasted state, the glucose supply is thought to be met by gluconeogenesis. Underweight women with low body mass index (BMI) might be unable to adequately supply amino acids to satisfy the demands of gluconeogenesis.Subjects/Methods:Glucose kinetics were measured during the first and second trimesters of pregnancy in 10 low-BMI and 10 normal-BMI pregnant women at the 12th hour of an overnight fast using a primed 6 h U-13C glucose infusion and was correlated to maternal dietary and anthropometric variables and birth weight.Results:Low-BMI mothers consumed more energy, carbohydrates and protein, had faster glucose production (R a) and oxidation rates in the first trimester. In the same trimester, dietary energy and carbohydrate correlated with glucose production, glycogenolysis and glucose oxidation in all women. Both groups had similar rates of gluconeogenesis in the first and second trimesters. Glucose R a in the second trimester was weakly correlated with the birth weight (r=0.4, P=0.07).Conclusions:Maternal energy and carbohydrate intakes, not BMI, appear to influence glucose R a and oxidation in early and mid pregnancy. [ABSTRACT FROM AUTHOR]

Background:Inadequate consumption of fish could be a risk factor for low birth weight (LBW). This study assessed fish intake and ω-3 LCPUFA intake and status for their association with LBW in a cohort of urban, south Indian pregnant women.Subjects/methods:In a prospective cohort study, data on maternal fish intake and ω-3 LCPUFA intake and status of 676 women were obtained at baseline (first trimester), the second and third trimesters of pregnancy. Infant birth weight was measured immediately following hospital delivery. The dropout rate was 7.6%.Results:Fifty-six percent of the study women consumed fish with low daily median intakes (3.4, 4.1 and 3.8 g day−1 at the three trimesters, respectively). Consequently, the median intakes of EPA and DHA during pregnancy were also low at 2.1 and 10.1 mg day−1, respectively. EPA and DHA intakes were associated with their status in erythrocyte membrane phospholipids during pregnancy (r=0.40 and 0.36, r=0.34 and 0.32 and r=0.37 and 0.41, at the three trimesters, respectively, all P<0.001). Women who did not eat fish during the third trimester had a significantly higher risk of LBW (OR: 2.49, P=0.019). Similarly, low EPA intake during the third trimester had an association with a higher risk of LBW (OR: 2.75, P=0.011).Conclusions:Among low fish-eating pregnant women, fish intake in the third trimester was closely associated with birth weight. Supplementation with ω-3 LCPUFA during pregnancy may have important implications for fetal development in India.European Journal of Clinical Nutrition (2009) 63, 340–346; doi:10.1038/sj.ejcn.1602933; published online 24 October 2007 [ABSTRACT FROM AUTHOR]

Earlier studies have shown a relationship between maternal vitamin B12 status and birth weight. This study extends those findings directly in terms of neonatal vitamin B12 status and birth weight. One hundred and twelve women were followed from the first trimester of pregnancy and maternal blood was obtained in all three trimesters along with cord blood at birth of their neonates. The maternal and cord serum vitamin B12 concentrations were examined in relation to birth weight. There was a significant correlation between vitamin B12 concentration in maternal antenatal serum during each of the trimesters of pregnancy and cord serum (all P<0.01). Neonates that were born with lower birth weights (categories of < 2500 g and 2500-2999 g) had significantly lower mean cord serum vitamin B12 concentrations when compared to those who were ≥ 3000 g (P = 0.02 and P = 0.05 respectively). A similar, however, non significant trend was observed for antenatal vitamin B12 concentrations at first and third trimesters. Cord serum vitamin B12 concentrations were significantly correlated with birth weight, up to 40 weeks of pregnancy (r=0.28, P=0.01) but not beyond that (≥ 40 weeks gestation). Vitamin B12 status in the mother was related to neonatal vitamin B12 status as measured by cord serum vitamin B12 concentration. In addition, low neonatal vitamin B12 concentrations were adversely associated with low birth weights. [ABSTRACT FROM AUTHOR]

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 2.85±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 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.European Journal of Clinical Nutrition (2006) 60, 791–801. doi:10.1038/sj.ejcn.1602383; published online 11 January 2006 [ABSTRACT FROM AUTHOR]