Variables in SCREENING FORM (SCR)
Question# Question Field name  Responses nature Response options
1 Screening Number      scr_1 ###  
2 Initials of the pregnant mother’s name scr_2 XX  
3 Date of interview
(according to English calendar)
scr_3 ##-XXX-##  dd-mmm-yy 
4 Researcher code    scr_4 ##  
5 Age of pregnant mother
(completed years)
scr_5 ##  
6 Date of Last Menstruation Period (LMP)
(according to English calendar)
scr_6 ##-XXX-##  dd-mmm-yy (99/999/99 if not known)
7 Gestation of pregnancy by LMP (weeks) scr_7 ##  
8 Gestation of pregnancy
according to USG report (weeks)
scr_8 ##  
9 Date of USG scanning
(according to English calender)
scr_8.i ##-XXX-##  dd-mmm-yy (99/999/99 if not known)
Evaluation for inclusion in the study (Code: 1=Yes, 2=No, 9=Not applicable). The pregnant mother is eligible to participate in the study if following answers are YES (code 1)
10 Pregnant mother’s age between 20 to 40 years? scr_9 # 1=Yes, 2=No
11 Pregnancy <15 weeks of gestation? scr_10 # 1=Yes, 2=No
12 Pregnant mother plans to live in the study area for the next 2 years? scr_11 # 1=Yes, 2=No
13 Pregnant mother/family consented for participation in the study? scr_12 # 1=Yes, 2=No, 9= Not applicable
Evaluation for exclusion (Code: 1=Yes, 2=No, 9=Not applicable). The pregnant mother is eligible to participate in the study if following answers are NO (code 2) 
14 Any acute illness (eg fever, diarrhea/ vomiting, acute respiratory infection etc) ? scr_13 # 1=Yes, 2=No
15 Any chronic illness / under any medication now (eg Hypertension, HIV, Tuberculosis, Diabetes, Thyroid disorder, Epilepsy, Chronic diarrhea etc)? scr_14 # 1=Yes, 2=No
16 If yes, specify.    scr_14 txt TXT TEXT if scr_14=1
NA if scr_14=2
17 H/O pregnancy complications like recurrent abortion? scr_15 # 1=Yes, 2=No
18 Suffering from any condition that requires treatment with vitamin B12? scr_16 3 1=Yes, 2=No
19 Taking or planning to take multivitamins that include vitamin B12? scr_17 3 1=Yes, 2=No
20 If yes, specify reason. scr_17 txt TXT TEXT if scr_14=1
NA if scr_14=2
21 Any problem on clinical examination? scr_18 # 1=Yes, 2=No, 9= Not applicable
22 If yes, specify.   scr_18 txt TXT TEXT if scr_14=1
NA if scr_14=2
23 Is current pregnancy a high risk? scr_19 # 1=Yes, 2=No, 9= Not applicable
24 If yes specify. scr_19 txt TXT TEXT if scr_14=1
NA if scr_14=2
25 Is hemoglobin level <7 g/dl or any other abnormal findings on blood test? scr_20 # 1=Yes, 2=No,
9= Not applicable if no lab report
26 Mid upper arm circumference (MUAC) (cm)? scr_21 ##.#  ##.# if measured
99.9 if not measured
27 Height of pregnant mother (cm) scr_21_a ###.# ###.# if measured
99.9 if not measured
28 Weight of pregnant mother (kgs) scr_21_b ##.##  ##.## if measured
99.9 if not measured
29 Is BMI (weight/height2) <18.5 or >30 Or MUAC <21cm? scr_21_c # 1=Yes, 2=No,
9= Not applicable if scr_21_a and scr_21_b are not measured
30 Participant Identification Number (As on the packet with supplement.) scr_22 ### ### if eligible to participate and given participation number
999 if ineligible to participate
31 Remarks   TXT