Mukhopadhyay A, et al. - Researchers evaluated the role of fetal sex in modifying the impact of maternal macronutrient intake on the risk of small-for-gestational-age (SGA) birth in this prospective, observational cohort study of 2,035 births from an urban South Asian Indian population. Maternal intakes of total energy and macronutrients were documented via validated food-frequency surveys. The investigators tested the interaction of first trimester macronutrient intake with fetal sex on the outcome of SGA births. Results demonstrated an association of higher carbohydrate and lower fat intakes with increased risk of male SGA births. Hence, it was theorized that in optimal fetoplacental growth, fetal sex acts as a modifier of the role of maternal periconceptional nutrition. Moreover, they noted a correlation of the dietary intake of > 70% of energy from carbohydrate with increased risk, whereas there was an association of > 25% of energy from the fat intake with decreased risk of SGA in male births.