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CompletedNCT03258385Updated Jan 18, 2023

Vitamin B12 Supplementation to Improve B12 Status and Child Development

An interventional study of Vitamin B12 fortified UHT milk and Plain UHT milk in Early Pregnancy, sponsored by International Centre for Diarrhoeal Disease Research, Bangladesh. Completed at 1 site in Bangladesh. Open to participants aged 18 Years to 35 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-01-18.

Sponsored by International Centre for Diarrhoeal Disease Research, Bangladesh · Not applicable, Interventional, and Health services research

Phase
Not applicable
Study type
Interventional
Enrollment
155
Allocation
Randomized
Ages
18 Years to 35 Years
Sex
All
01

Study summary

Impaired vitamin B12 (B12) status during pregnancy is associated with increased risk of birth defects and common complications (e.g. intrauterine growth restriction, neural tube defects), and possibly immune function impairment. The newborns and infants of B12-deficient mothers have low B12 stores at birth, further exacerbated by a very low concentration of B12 in breast milk that may hinder their growth and development. In regions such as Bangladesh, many women of reproductive age have inadequate B12 status, probably due to low intake of animal source food. Vitamin B12 intake and status in pregnancy and lactation is potentially insufficient to prevent impaired child development and immune function related to inadequate B12 status. The investigators hypothesize that prolonged vitamin B12 supplementation through fortified milk starting from early pregnancy up to 6 mo-postpartum will improve: (1) biomarkers of vitamin B12 status in mothers-infant pairs (2) vaccine specific adaptive immunity in infants; (3) neurological and cognitive function in infants.

Read the detailed description

The investigators aim to conduct a double-blind, randomized trial, to investigate the effects of B12-fortified milk on maternal and infant B12 status, immune function and child development. Pregnant women (n=148) will be randomized to receive B12-fortified milk (100 μg/day) or milk without fortification. The daily supplementation beginning at the baseline visit (GW 11-14) will continue until 6 mo-postpartum. Biomarkers of B12 status will be measured in mothers (GW 11-14 and 6-mo postpartum) and infants (3 and 6-mo). Infant development (6 and 12-mo) will be evaluated by Bayley Scales of Infant and Toddler Development. Immune responses will be measured in infant at 3 and 6-mo. Data on socioeconomic status, dietary diversity, and anthropometric indices will be recorded at baseline. Additional tests in mothers include screening for H. pylori and plasma gastrin.

02

Conditions studied

  • Early Pregnancy

Keywords

  • Vitamin B12, Fortified milk, Immunity, Child development
03

Who can participate

Ages eligible
18 Years to 35 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  1. 18 - 35 y old 2. 11-14 wk pregnant (based on last menstrual period) 3. Willing to stay in Dhaka during pregnancy and remain in the area for the 12 mo following recruitment 4. Willing to be admitted in the clinic for delivery 5. Intends to exclusively or predominantly breastfeed infant until 6 mo of age

Exclusion criteria

-

Exclusion Criteria:

  1. Women with severe anemia; Hb concentration \<70 g/L 2. History or presence of systemic disease such as Diabetes mellitus, Hypertension 3. History of previous complicated pregnancies, pre-term delivery, or abortion 4. Current use of supplements containing vitamin B12 5. Children with acute illness or features suggestive of any chronic disease such as tuberculosis, any congenital anomalies such as cleft lip or palate.

-

04

Study design

Phase
Not applicable
Primary purpose
Health services research
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
155 participants (actual)

Study arms

  • Active comparator
    Vitamin B12-fortified UHT milk

    Supplementation group (N=74) that will receive vitamin B12 fortified UHT milk daily

    Dietary Supplement: Vitamin B12 fortified UHT milk

  • Placebo comparator
    Plain UHT milk

    Placebo group (N=74) that will receive plain UHT milk daily

    Dietary Supplement: Plain UHT milk

Interventions

  • Dietary supplementVitamin B12 fortified UHT milk

    Daily intake of 200 mL of UHT milk fortified with 100 µg vitamin B12

  • Dietary supplementPlain UHT milk

    Daily intake of 200 mL of plain UHT milk

05

What researchers measure

Primary outcomes

  1. Change in concentrations of biomarkers of vitamin B12 in mother-child pairs

    The investigators will determine the change in concentrations of biomarkers of B12 ( based on measurement of B12, MMA, tHcy, holoTC, cB12, folate in plasma; B12 in breast milk)

    Time frame: Baseline and 6 months postpartum

  2. Vaccine specific immunity in infants

    The investigators will determine the concentrations of vaccine specific IgA and IgG in plasma

    Time frame: 6 months

  3. Cognitive, Language and Motor Composite Score

    The outcomes are measured by Bayley-III test

    Time frame: 12 months

  4. Nuroinflammatory cytokines

    The investigators will determine the change in concentrations of EGF and TNF-α in plasma

    Time frame: 12 months

06

Study locations

1 site
  • Maternal and Child Health Training Institute
    Dhaka, 1205, Bangladesh
07

Registry details

Key details

Study ID
NCT03258385
Lead sponsor
International Centre for Diarrhoeal Disease Research, Bangladesh
Collaborators
University of California, Davis, Nestlé Foundation
Responsible party
Sponsor
First posted
Aug 23, 2017
Start date
Sep 1, 2017
Primary completion
Oct 30, 2021
Completion
Oct 30, 2021
Last update
Jan 18, 2023

Study contacts

Towfida J Siddiqua, PhD
principal investigator · International Centre for Diarrhoeal Disease Research, Bangladesh

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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