Antenatal Vitamin D3 Dose-finding and Safety Study

NCT ID: NCT00938600

Last Updated: 2012-08-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-07-31

Study Completion Date

2010-06-30

Brief Summary

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This is a preliminary study of oral vitamin D3 supplementation in pregnant and non-pregnant women of reproductive age in Bangladesh. The primary objective of the study is to identify a dose of vitamin D3 that can safely be administered during pregnancy to improve the vitamin D status of the mother and infant.

Detailed Description

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Vitamin D deficiency is common among pregnant and non-pregnant Bangladeshi women. The consequences of vitamin D deficiency during pregnancy are unknown, but increasing evidence suggests it may compromise fetal growth and development of the immune system. We hypothesize that vitamin D deficiency in pregnant women has an adverse effect on the newborn's defenses against infectious diseases in early infancy, and thus contributes to the high rates of neonatal mortality in South Asia. Randomized controlled trials of antenatal vitamin D supplementation are needed to test this hypothesis. However, preliminary studies are first necessary to establish a safe and efficacious dose of vitamin D to be used in such trials. In the proposed study, we will measure the response of the 25-hydroxyvitamin D serum concentration (a biomarker of vitamin D status) to oral vitamin D3 supplementation in pregnant women and non-pregnant women of reproductive age. The goal is to establish a safe, efficacious and feasible weekly vitamin D supplementation regimen for use in future trials. Five groups of approximately 15 women (3 groups of pregnant and 2 groups of non-pregnant women; total up to 75 women) will be supplemented and followed closely for 10 weeks (non-pregnant women) or until delivery (pregnant participants). The primary outcomes will be the change in 25-hydroxyvitamin D concentrations following vitamin D supplementation, and safety parameters that reflect calcium regulation (serum albumin-adjusted calcium concentrations and urine calcium excretion) and fetal development.

Conditions

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Pregnancy Nutritional Status Vitamin D

Keywords

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pharmacokinetics safety

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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A1 - non-pregnant single-dose

Group Type EXPERIMENTAL

Vitamin D3

Intervention Type DIETARY_SUPPLEMENT

Vitamin D3 oral liquid 70,000 IU once

A2 - non-pregnant; weekly dose

Group Type EXPERIMENTAL

Vitamin D3

Intervention Type DIETARY_SUPPLEMENT

Vitamin D3 oral liquid 70,000 IU as loading dose, then 35,000 IU weekly thereafter for 10 weeks (non-pregnant) or until delivery (pregnant)

B1 - pregnant; single-dose

Group Type EXPERIMENTAL

Vitamin D3

Intervention Type DIETARY_SUPPLEMENT

Vitamin D3 oral liquid 70,000 IU once

B2 - pregnant; weekly dose

Group Type EXPERIMENTAL

Vitamin D3

Intervention Type DIETARY_SUPPLEMENT

Vitamin D3 oral liquid 70,000 IU as loading dose, then 35,000 IU weekly thereafter for 10 weeks (non-pregnant) or until delivery (pregnant)

C1 - active control; pregnant women

Group Type ACTIVE_COMPARATOR

Vitamin D3

Intervention Type DIETARY_SUPPLEMENT

Vitamin D3 14,000 IU per week by mouth, starting at 27-30 weeks gestation and continued until delivery.

Interventions

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Vitamin D3

Vitamin D3 oral liquid 70,000 IU once

Intervention Type DIETARY_SUPPLEMENT

Vitamin D3

Vitamin D3 oral liquid 70,000 IU as loading dose, then 35,000 IU weekly thereafter for 10 weeks (non-pregnant) or until delivery (pregnant)

Intervention Type DIETARY_SUPPLEMENT

Vitamin D3

Vitamin D3 14,000 IU per week by mouth, starting at 27-30 weeks gestation and continued until delivery.

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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Cholecalciferol Vigantol Oil Cholecalciferol Vigantol Oil Cholecalciferol Vigantol Oil

Eligibility Criteria

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Inclusion Criteria

* Healthy women, age 18 to \< 35 years, who are clients at the Shimantik clinic or friends/relatives of Shimantik clients.
* Current permanent residence in Dhaka at a fixed address, and have plans to stay in Dhaka for at least 4 months.
* Pregnant women: Enrolled between 26th and 30th week of gestation (participants enrolled in 26th week will not start on-study until the 27th week or later), with a normal medical and obstetric history. Gestational age will be estimated based on the first day of the last menstrual period (LMP).
* Informed consent provided after having an opportunity to consult with husband and/or family members.

Exclusion Criteria

* Current self-reported use of any non-food-based dietary supplements containing vitamin D (i.e., commercial micronutrient pills or capsules containing vitamin D).
* Current use of anti-convulsant or anti-mycobacterial (tuberculosis) medications.
* Severe anemia (hemoglobin concentration \< 70 g/L).
* Hypertension (systolic blood pressure \>= 140 mmHg or diastolic blood pressure \>= 90 mmHg on at least two measurements).
* In pregnant women: previous history of giving birth to an infant with congenital anomalies.
* In non-pregnant women: currently breast-feeding.
Minimum Eligible Age

18 Years

Maximum Eligible Age

34 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Johns Hopkins University

OTHER

Sponsor Role collaborator

Johns Hopkins Bloomberg School of Public Health

OTHER

Sponsor Role lead

Responsible Party

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Abdullah Baqui

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Abdullah Baqui, MBBS

Role: PRINCIPAL_INVESTIGATOR

The Johns Hopkins Bloomberg School of Public Health

Rubhana Raqib, PhD

Role: PRINCIPAL_INVESTIGATOR

International Centre for Diarrhoeal Disease Research, Bangladesh

Shams El Arifeen, MBBS

Role: PRINCIPAL_INVESTIGATOR

International Centre for Diarrhoeal Disease Research, Bangladesh

Daniel E Roth, MD

Role: STUDY_DIRECTOR

The Johns Hopkins Bloomberg School of Public Health

Locations

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SHIMANTIK Maternity Centre

Dhaka, Dhaka Division, Bangladesh

Site Status

Countries

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Bangladesh

References

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Islam MZ, Shamim AA, Kemi V, Nevanlinna A, Akhtaruzzaman M, Laaksonen M, Jehan AH, Jahan K, Khan HU, Lamberg-Allardt C. Vitamin D deficiency and low bone status in adult female garment factory workers in Bangladesh. Br J Nutr. 2008 Jun;99(6):1322-9. doi: 10.1017/S0007114508894445.

Reference Type BACKGROUND
PMID: 18430266 (View on PubMed)

Islam MZ, Lamberg-Allardt C, Karkkainen M, Outila T, Salamatullah Q, Shamim AA. Vitamin D deficiency: a concern in premenopausal Bangladeshi women of two socio-economic groups in rural and urban region. Eur J Clin Nutr. 2002 Jan;56(1):51-6. doi: 10.1038/sj.ejcn.1601284.

Reference Type BACKGROUND
PMID: 11840180 (View on PubMed)

Palacios C, Kostiuk LL, Cuthbert A, Weeks J. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev. 2024 Jul 30;7(7):CD008873. doi: 10.1002/14651858.CD008873.pub5.

Reference Type DERIVED
PMID: 39077939 (View on PubMed)

Roth DE, Al Mahmud A, Raqib R, Black RE, Baqui AH. Pharmacokinetics of a single oral dose of vitamin D3 (70,000 IU) in pregnant and non-pregnant women. Nutr J. 2012 Dec 27;11:114. doi: 10.1186/1475-2891-11-114.

Reference Type DERIVED
PMID: 23268736 (View on PubMed)

Other Identifiers

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JHU-1819

Identifier Type: -

Identifier Source: org_study_id