Cohort profile: the Maharashtra Anaemia Study 3 (MAS 3)—a maternal-child cohort study up to age 18 years in India

Melissa T Benavente; Nophar Geifman; Sarah C Bath; Kourosh R Ahmadi; Andrew W Fogarty; Charles Marshall; Sumantra Ray; Laila J Tata; Chittaranjan Yajnik; Anand Ahankari

doi:10.1136/bmjopen-2025-104184

Cohort profile: the Maharashtra Anaemia Study 3 (MAS 3)—a maternal-child cohort study up to age 18 years in India

Melissa T Benavente
, Nophar Geifman
, Sarah C Bath
, Kourosh R Ahmadi
, Andrew W Fogarty
, Charles Marshall
, Sumantra Ray
, Laila J Tata
, Chittaranjan Yajnik
, Anand Ahankari

Research output: Contribution to journal › Article › peer-review

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Abstract

Purpose: The Maharashtra Anaemia Study 3 (MAS 3) aims to (1) Investigate the nutritional, environmental, and economic impacts on haemoglobin concentration/anaemia, (2) Identify the underlying micronutrient causes of anaemia and (3) Investigate the association between anaemia and physical and cognitive development of Indian children during their first 18 years of life. This paper introduces the MAS 3 cohort, which consists of data collected from the participants in the prospective Pune Maternal Nutrition Study from the antenatal period to children at 18 years of age (1996–2014) in the Maharashtra state, India. Participants: Recruitment of 2466 married non-pregnant women, and their husbands, took place between June 1994 and April 1996 in six villages, approximately 50 km from Pune city in India. Women were followed up monthly to identify those who became pregnant. A total of 797 pregnant women were followed up for data collection at or near gestational week 18 and 28, with further data collection for women and children occurring within 72 hours of delivery, for both live and stillbirths. Of the 797 women, 710 were included in the MAS 3 cohort, and long-term follow-up of children occurred at 6 years, 12 years and 18 years of age. Findings to date: In the MAS 3 cohort, most mothers (73%) were aged between 18 and 25 years at the time of their final prepregnancy visit (baseline), and half (55%) belonged to families of middle-upper socioeconomic status (SES). At the children’s baseline (birth) visit, children had a mean birth weight of 2630 g (SD: 376), with one third (31%) of low birth weight. At the 6-year, 12-year and 18-year follow-up visits, data were available for 706 (99%), 689 (97%) and 694 (98%) children. Future plans: MAS 3 will be used to address a number of research objectives, including (1) Trends of haemoglobin and anaemia-related micronutrients from age 6 to 18 years, (2) Micronutrient causes of anaemia during childhood, (3) Prevalence and risk factors for maternal anaemia and childhood anaemia, (4) Impact of maternal anaemia on immediate birth outcomes and (5) Intergenerational risk factors associated with anaemia.

Original language	English
Article number	e104184
Pages (from-to)	1-11
Number of pages	11
Journal	BMJ Open
Volume	15
Issue number	10
Early online date	28 Oct 2025
DOIs	https://doi.org/10.1136/bmjopen-2025-104184
Publication status	Published (in print/issue) - 28 Oct 2025

Bibliographical note

Data Availability Statement

Data may be obtained from a third party and are not publicly available. Although the MAS 3 data are not publicly available due to legal restrictions, access to the data may be available upon individual request approval and with a collaboration agreement approved by the KEMHRC and its ethics committee.

Funding

The data and samples included in the MAS 3 study were originally collected as part of the Pune Maternal Nutrition Study (PMNS) and were initially funded by the Wellcome Trust, UK (038128/Z/93). The PMNS and the Diabetes Unit also received funding from other agencies over time to implement research activities. The development of a dataset for secondary analysis was part of the MAS 3 project. Funding for the MAS 3 project was received from the QR Global Research Fund (GCRF) and allocated to the University of Surrey, UK, for the 2020-21 programme (Ref: AN9520). Analyses of the MAS 3 dataset have been funded as part of the University of Surrey, Doctoral College PhD programme studentship award to MB (2022-26, Ref: FHMS PL-BM-23, TE4026).

Funders	Funder number
University of Surrey	FHMS PL-BM-23, AN9520, TE4026, 2022-26
Wellcome Trust	038128/Z/93

Keywords

EPIDEMIOLOGY
Pregnancy
Child
India
Anaemia
Hemoglobins/analysis
India/epidemiology
Prospective Studies
Humans
Child, Preschool
Infant
Male
Anemia/epidemiology
Young Adult
Micronutrients
Adolescent
Adult
Female
Child Development
Nutritional Status
Infant, Newborn
Cohort Studies

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Cite this

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title = "Cohort profile: the Maharashtra Anaemia Study 3 (MAS 3)—a maternal-child cohort study up to age 18 years in India",

abstract = "Purpose: The Maharashtra Anaemia Study 3 (MAS 3) aims to (1) Investigate the nutritional, environmental, and economic impacts on haemoglobin concentration/anaemia, (2) Identify the underlying micronutrient causes of anaemia and (3) Investigate the association between anaemia and physical and cognitive development of Indian children during their first 18 years of life. This paper introduces the MAS 3 cohort, which consists of data collected from the participants in the prospective Pune Maternal Nutrition Study from the antenatal period to children at 18 years of age (1996–2014) in the Maharashtra state, India. Participants: Recruitment of 2466 married non-pregnant women, and their husbands, took place between June 1994 and April 1996 in six villages, approximately 50 km from Pune city in India. Women were followed up monthly to identify those who became pregnant. A total of 797 pregnant women were followed up for data collection at or near gestational week 18 and 28, with further data collection for women and children occurring within 72 hours of delivery, for both live and stillbirths. Of the 797 women, 710 were included in the MAS 3 cohort, and long-term follow-up of children occurred at 6 years, 12 years and 18 years of age. Findings to date: In the MAS 3 cohort, most mothers (73\%) were aged between 18 and 25 years at the time of their final prepregnancy visit (baseline), and half (55\%) belonged to families of middle-upper socioeconomic status (SES). At the children{\textquoteright}s baseline (birth) visit, children had a mean birth weight of 2630 g (SD: 376), with one third (31\%) of low birth weight. At the 6-year, 12-year and 18-year follow-up visits, data were available for 706 (99\%), 689 (97\%) and 694 (98\%) children. Future plans: MAS 3 will be used to address a number of research objectives, including (1) Trends of haemoglobin and anaemia-related micronutrients from age 6 to 18 years, (2) Micronutrient causes of anaemia during childhood, (3) Prevalence and risk factors for maternal anaemia and childhood anaemia, (4) Impact of maternal anaemia on immediate birth outcomes and (5) Intergenerational risk factors associated with anaemia.",

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T1 - Cohort profile: the Maharashtra Anaemia Study 3 (MAS 3)—a maternal-child cohort study up to age 18 years in India

AU - Benavente, Melissa T

AU - Geifman, Nophar

AU - Bath, Sarah C

AU - Ahmadi, Kourosh R

AU - Fogarty, Andrew W

AU - Marshall, Charles

AU - Ray, Sumantra

AU - Tata, Laila J

AU - Yajnik, Chittaranjan

AU - Ahankari, Anand

N1 - © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.

PY - 2025/10/28

Y1 - 2025/10/28

N2 - Purpose: The Maharashtra Anaemia Study 3 (MAS 3) aims to (1) Investigate the nutritional, environmental, and economic impacts on haemoglobin concentration/anaemia, (2) Identify the underlying micronutrient causes of anaemia and (3) Investigate the association between anaemia and physical and cognitive development of Indian children during their first 18 years of life. This paper introduces the MAS 3 cohort, which consists of data collected from the participants in the prospective Pune Maternal Nutrition Study from the antenatal period to children at 18 years of age (1996–2014) in the Maharashtra state, India. Participants: Recruitment of 2466 married non-pregnant women, and their husbands, took place between June 1994 and April 1996 in six villages, approximately 50 km from Pune city in India. Women were followed up monthly to identify those who became pregnant. A total of 797 pregnant women were followed up for data collection at or near gestational week 18 and 28, with further data collection for women and children occurring within 72 hours of delivery, for both live and stillbirths. Of the 797 women, 710 were included in the MAS 3 cohort, and long-term follow-up of children occurred at 6 years, 12 years and 18 years of age. Findings to date: In the MAS 3 cohort, most mothers (73%) were aged between 18 and 25 years at the time of their final prepregnancy visit (baseline), and half (55%) belonged to families of middle-upper socioeconomic status (SES). At the children’s baseline (birth) visit, children had a mean birth weight of 2630 g (SD: 376), with one third (31%) of low birth weight. At the 6-year, 12-year and 18-year follow-up visits, data were available for 706 (99%), 689 (97%) and 694 (98%) children. Future plans: MAS 3 will be used to address a number of research objectives, including (1) Trends of haemoglobin and anaemia-related micronutrients from age 6 to 18 years, (2) Micronutrient causes of anaemia during childhood, (3) Prevalence and risk factors for maternal anaemia and childhood anaemia, (4) Impact of maternal anaemia on immediate birth outcomes and (5) Intergenerational risk factors associated with anaemia.

AB - Purpose: The Maharashtra Anaemia Study 3 (MAS 3) aims to (1) Investigate the nutritional, environmental, and economic impacts on haemoglobin concentration/anaemia, (2) Identify the underlying micronutrient causes of anaemia and (3) Investigate the association between anaemia and physical and cognitive development of Indian children during their first 18 years of life. This paper introduces the MAS 3 cohort, which consists of data collected from the participants in the prospective Pune Maternal Nutrition Study from the antenatal period to children at 18 years of age (1996–2014) in the Maharashtra state, India. Participants: Recruitment of 2466 married non-pregnant women, and their husbands, took place between June 1994 and April 1996 in six villages, approximately 50 km from Pune city in India. Women were followed up monthly to identify those who became pregnant. A total of 797 pregnant women were followed up for data collection at or near gestational week 18 and 28, with further data collection for women and children occurring within 72 hours of delivery, for both live and stillbirths. Of the 797 women, 710 were included in the MAS 3 cohort, and long-term follow-up of children occurred at 6 years, 12 years and 18 years of age. Findings to date: In the MAS 3 cohort, most mothers (73%) were aged between 18 and 25 years at the time of their final prepregnancy visit (baseline), and half (55%) belonged to families of middle-upper socioeconomic status (SES). At the children’s baseline (birth) visit, children had a mean birth weight of 2630 g (SD: 376), with one third (31%) of low birth weight. At the 6-year, 12-year and 18-year follow-up visits, data were available for 706 (99%), 689 (97%) and 694 (98%) children. Future plans: MAS 3 will be used to address a number of research objectives, including (1) Trends of haemoglobin and anaemia-related micronutrients from age 6 to 18 years, (2) Micronutrient causes of anaemia during childhood, (3) Prevalence and risk factors for maternal anaemia and childhood anaemia, (4) Impact of maternal anaemia on immediate birth outcomes and (5) Intergenerational risk factors associated with anaemia.

KW - EPIDEMIOLOGY

KW - Pregnancy

KW - Child

KW - India

KW - Anaemia

KW - Hemoglobins/analysis

KW - India/epidemiology

KW - Prospective Studies

KW - Humans

KW - Child, Preschool

KW - Infant

KW - Male

KW - Anemia/epidemiology

KW - Young Adult

KW - Micronutrients

KW - Adolescent

KW - Adult

KW - Female

KW - Child Development

KW - Nutritional Status

KW - Infant, Newborn

KW - Cohort Studies

UR - https://www.scopus.com/pages/publications/105020181701

U2 - 10.1136/bmjopen-2025-104184

DO - 10.1136/bmjopen-2025-104184

M3 - Article

C2 - 41151957

SN - 2044-6055

VL - 15

SP - 1

EP - 11

JO - BMJ Open

JF - BMJ Open

IS - 10

M1 - e104184

ER -

Cohort profile: the Maharashtra Anaemia Study 3 (MAS 3)—a maternal-child cohort study up to age 18 years in India

Abstract

Bibliographical note

Data Availability Statement

Funding

Keywords

Access to Document

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