Effect of Parental Peri-conceptional Vitamin B12 Supplementation on Infant Neurocognitive Development in Offspring

NCT ID: NCT03088189

Last Updated: 2023-10-10

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

TERMINATED

Total Enrollment

85 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-05-09

Study Completion Date

2022-03-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Maternal nutrition is an important factor which determines fetal growth and development. Micronutrients vitamin B12 and folic acid are essential determinants of one carbon metabolism and play an important role in DNA synthesis, methylation and epigenetic regulation of gene expression. Diabetes unit of KEMHRC, Pune has been conducting the Pune Rural Intervention in Young Adolescents since last 3 years. Subjects of the PMNS cohort have been randomized as part of a controlled trial of nutritional intervention with vitamin B12 vs multiple micronutrient and milk protein vs placebo. This study aims to understand the intergenerational effects of vitamin B12 supplementation. 74 infants have been born in this trial since 2013. This study would assess neurocognitive development of offspring born to mothers who are part of the nutritional intervention trial; on the Bayley scales of infant and toddler development - III. The study aims to test the hypothesis that infants born to mothers who received vitamin B12 would have favorable infant neurocognitive development scores as compared to placebo. And this effect would be enhanced in the group whose mothers received MMN with milk protein.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Background:

The concept of fetal programming suggests that adverse intrauterine growth environment influences development of fetal organ structure and function, hence laying the basis for risk for chronic disease in later life with its consequent effects on human capital. One of the important factors determining intrauterine growth is maternal and fetal nutritional status. Micronutrients vitamin B12 and folic acid are essential determinants of one carbon metabolism and play an important role in DNA synthesis, methylation and epigenetic regulation of gene expression. The ongoing Pune Maternal Nutritional Study (PMNS) has demonstrated an association between low maternal vitamin B12 levels during pregnancy and impaired cognitive functioning in offspring at 9 and 12 years of age. This observation suggests that maternal micronutrient status during pregnancy can influence neurocognitive development and functioning in later life. Various other intervention studies conducted in Delhi and Bangladesh support that vitamin B12 and folic acid supplementation in children between 6-30 months of age can improve their motor and neurocognitive development. On this background the Diabetes unit of KEMHRC, Pune has been conducting the Pune Rural Intervention in Young Adolescents since last 3 years. Subjects of the PMNS cohort have been randomized as part of a controlled trial of nutritional intervention with vitamin B12 vs multiple micronutrient and milk protein vs placebo. This study aims to understand the intergenerational effects of vitamin B12 supplementation. 74 infants have been born in this trial since 2013. This presents a unique opportunity to study the effects of parental periconceptional vitamin B12 supplementation on infant neurocognitive development.

Objective and Hypothesis:

To compare group differences, in infant neurocognitive development scores assessed at 24 months of age between mothers who received either vitamin B12 alone, or MMN with milk protein or placebo.

Hypothesis: Infants born to mothers who received vitamin B12 would have favorable infant neurocognitive development scores as compared to placebo. And this effect would be enhanced in the group whose mothers received MMN with milk protein.

Methods:

Study subjects:

The study subjects will include infants born to parents who are enrolled in the PRIYA trial. As of August 2016, 74 infants have been born in the trial the oldest being born in June 2013. The subject recruitment will be ongoing and any infants born subsequently will also be included.

Procedure:

After institutional and ethical clearance, parents of infants approaching 24 months of age would be approached for study and informed consent obtained from the parents. The infant with parent would be brought to KEM hospital after scheduling an appointment. Assessment Bayley scales of infant and toddler development - III would be performed at the TDH center of KEM hospital by a trained assessor. All assessments would be performed at age of 24±2 months. For infants who are already older than 24 months assessment would be performed at their current age after obtaining approval for the study from the institutional ethics committee.

Tool:

The Bayley scales of infant and toddler development - III is a standardized instrument for assessing motor and neurocognitive development in infants. The scale assess development on the domains of cognitive, receptive communication, expressive communication, fine motor, gross motor, socio-emotional. The scale provides a general adaptive composite score along with scores on the individual domains.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Neurodevelopmental Disorders

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Vitamin B12 group

Mothers in the group are receiving vitamin B12 2µg supplements daily

No interventions assigned to this group

Multiple micronutrient group

mothers in this group are receiving vitamin B12 2µg plus multiple micronutrients (MMN) plus 20g of milk powder

No interventions assigned to this group

Placebo

Mothers are receiving placebo

No interventions assigned to this group

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Infants born to parent enrolled in the PRIYA trial
2. Age \> 24 months and \< 48 months
3. Informed consent obtained from parents

Exclusion Criteria

1. Infants diagnosed to have known genetic syndromes with mental retardation or cerebral palsy
2. Infants with recent immunization or febrile illness will be assessed 1 week after resolution
Minimum Eligible Age

2 Years

Maximum Eligible Age

4 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Kem Hospital, Pune, India

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Dr. Chittaranjan S Yajnik

Director, Diabetes Unit

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Chittaranjan Yajnik, MD

Role: PRINCIPAL_INVESTIGATOR

KEM Hospital research center, Pune

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Diabetes Unit, Kem Hospital Research Centre

Pune, Maharashtra, India

Site Status

Countries

Review the countries where the study has at least one active or historical site.

India

Related Links

Access external resources that provide additional context or updates about the study.

http://kemdiabetes.org

Official webpage of diabetes unit KEM hospital research center Pune

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

KEMHRC/ADHOC/25

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.