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Maternal Vitamin D for Infant Growth (MDIG) Trial

Phase 3
Completed
Conditions
Pregnancy
Registration Number
NCT01924013
Lead Sponsor
The Hospital for Sick Children
Brief Summary

The primary aims of this study are: 1) to determine whether maternal prenatal vitamin D3 supplementation (4200 IU/week, 16,800 IU/week, or 28,000 IU/week) versus placebo increases or decreases infant length at 1 year of age, and 2) to determine whether maternal postpartum vitamin D3 supplementation (28,000 IU/week) versus placebo increases or decreases length at 1 year of age among infants born to women who received vitamin D 28,000 U/week during pregnancy. Infants enrolled in the study will be followed for 2 years to document the persistence of any observed effects measured at 1 year of age. This study aims to enroll 1300 pregnant women in the 2nd trimester at a maternity hospital in Dhaka. Participants will be randomized to one of three doses of vitamin D3 (4200 IU/week, 16,800 IU/week, or 28,000 IU/week) or placebo throughout pregnancy. Women in the 28,000 IU/week group will be additionally randomized to either placebo or a continuation of 28,000 IU/week for 6 months postpartum. In addition to linear length, the trial will include analyses of inflammatory and hormonal determinants of infant growth, epigenetic phenomena that affect vitamin D metabolism, and diarrheal and respiratory morbidity in the infants.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
1300
Inclusion Criteria
  • Women aged 18 years and above.
  • Gestational age of 17 to 24 completed weeks estimated based on recalled last menstrual period (LMP) and/or ultrasound.
  • Intends to permanently reside in the trial catchment area for at least 18 months.
Exclusion Criteria
  • History of medical conditions that may predispose the participant to vitamin D sensitivity, altered vitamin D metabolism and/or hypercalcemia, or history of renal calculi.

  • High-risk pregnancy based on one or more of the following findings by point-of-care testing:

    • Severe anemia: hemoglobin <70 g/L assessed by Hemocue
    • Moderate-severe proteinuria: ≥ 300 mg/dl (3+ or 4+) based on urine dipstick
    • Hypertension: systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg
  • Multiple gestation, major congenital anomaly, or severe oligohydramnios based on maternal history and/or ultrasound.

  • Unwillingness to stop taking non-study vitamin D or calcium supplements or a multivitamin with calcium and/or vitamin D.

  • Currently prescribed vitamin D supplements as part of a physician's treatment plan for vitamin D deficiency.

  • Previous participation in the same study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Infant Length-for-Age Z-Scores with Prenatal Supplementation1 year of age
Infant Length-for-Age Z-Scores with Postpartum Supplementation1 year of age

A separate analysis will be performed to assess the effect of continuation of 28,000 IU/week postpartum supplementation versus placebo (postpartum) among participants randomized to 28,000 IU/week prenatal.

Secondary Outcome Measures
NameTimeMethod
Serum calcium17 weeks gestation to birth (prenatal) and over 2 years postpartum

Maternal serum calcium will be measured during pregnancy as a primary biochemical safety parameter and post partum.

Trial Locations

Locations (1)

International Centre for Diarrhoeal Disease Research, Bangladesh

🇧🇩

Dhaka, Bangladesh

International Centre for Diarrhoeal Disease Research, Bangladesh
🇧🇩Dhaka, Bangladesh

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