Pregnancy Salt Substitution Trial for Hypertensive Disorders of Pregnancy Prevention (PREG-Salt)

NCT ID: NCT07294807

Last Updated: 2025-12-29

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

3200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-25

Study Completion Date

2027-12-25

Brief Summary

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The PREG-Salt study is to evaluate the effect, safety and cost-effectiveness of low-sodium salt in reducing blood pressure and preventing hypertensive disorders in pregnant women at high risk in China. The study will recruit about 3,200 participants from approximately 100 hospitals across multiple provinces in China. Eligible pregnant women (≤16 weeks of gestation) will be randomly assigned in a 1:1 ratio to the following 2 groups:

1. Salt subsittute(intervention);
2. Usual salt (control) .

The intervention will last until delivery. The study employs an adaptive two-phase design. An interim analysis after the first phase (n=400) will inform whether the trial continues into the second phase and if any adjustments to the sample size are needed. The primary outcomes are:

Phase 1: The mean systolic blood pressure across antenatal visits (excluding the last week before delivery).

Phase 2: New-onset hypertensive disorders of pregnancy and related adverse events from randomization to delivery.

Detailed Description

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The PREG-Salt study is to evaluate the effect, safety and cost-effectiveness of low-sodium salt in reducing blood pressure and preventing hypertensive disorders in pregnant women at high risk in China. Specifically, the study aims include:

1. to evaluate whether salt substitute significantly reduces mean blood pressure, while observing adherence and safety, in a high-risk population for hypertensive disorders of pregnancy.
2. to further evaluate whether salt substitute significantly reduces the incidence of hypertensive disorders of pregnancy, while assessing its safety and cost-effectiveness.

The study is a two-phase, multicenter, randomized, double-blind, parallel-group controlled study. High-risk pregnant women at ≤16 weeks of gestation will be enrolled and randomly assigned in a 1:1 ratio to either the salt substitute(intervention) group or the usual salt (control) group. The study salt will be provided free of charge until delivery. Follow-up will be conducted through all antenatal visits and delivery to collect blood pressure data and information on the incidence of hypertensive disorders of pregnancy (including gestational hypertension, preeclampsia, eclampsia, death, stillbirth, preterm birth, etc.). The study employs an adaptive design. An interim analysis will be conducted after the completion of the first phase. Based on pre-specified efficacy and safety criteria, a decision will be made regarding the continuation of the study and potential adjustments to the subsequent sample size and randomization ratio.

The study will recruit about 3,200 participants(400 participants in the first phase) from approximately 100 hospitals (with an annual delivery volume of \>1,000) at the county level or above, across multiple provinces in China.

Inclusion Criteria:

1. Singleton pregnancy with a viable fetus at ≤16 weeks of gestation.
2. Meets at least one of the following criteria (enrolled sequentially):

1. Systolic Blood Pressure (SBP) ≥130 mmHg and \<160 mmHg at enrollment, OR current monotherapy with antihypertensive medications such as labetalol or nifedipine (priority enrollment).
2. At least one of the following 4 items: advanced maternal age (≥35 years), pre-pregnancy obesity (BMI ≥28 kg/m²), history of preeclampsia, or pre-existing type 1 or type 2 diabetes.
3. At least two of the following 5 items: history of adverse pregnancy outcome (e.g., fetal death, placental abruption, fetal growth restriction), personal history of gestational hypertension or family history of preeclampsia (mother or sister), history of gestational diabetes, obstructive sleep apnea, or pre-pregnancy overweight (BMI 24-28 kg/m²).
3. Routinely eats at least two meals per day at home (including meals brought from home).
4. Able to attend regular antenatal check-ups and is expected to complete the study follow-up.
5. Provides written informed consent.

Exclusion Criteria:

1. SBP ≥160 mmHg or Diastolic Blood Pressure (DBP) ≥110 mmHg at enrollment.
2. Conditions or history associated with high uterine tension (e.g., polyhydramnios, macrosomia, hydatidiform mole); autoimmune diseases (e.g., systemic lupus erythematosus, antiphospholipid syndrome).
3. History of chronic kidney disease, OR any antenatal check-up with a confirmed estimated Glomerular Filtration Rate (eGFR) \<70 ml/min/1.73m², OR dipstick urine protein ≥2+.
4. A confirmed diagnosis of hyperkalemia.
5. History of hypotension or syncope.
6. A household member who shares meals has a confirmed diagnosis of chronic kidney disease or hyperkalemia.

Outcome Measures:

Primary outcomes:

Phase 1: Mean change in systolic blood pressure. Phase 2: New-onset Hypertensive Disorders of Pregnancy and Related Maternal Adverse Events

Conditions

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Hypertensive Disorders of Pregnancy

Keywords

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Sodium reduction Pregnancy disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Potassium-Enriched Salt substitutes

Participants will use a potassium-enriched salt substitute in place of usual salt for home-prepared meals. The study salt substitute consists of 25% potassium chloride and 75% sodium chloride.

Group Type EXPERIMENTAL

Potassium-enriched salt substitute

Intervention Type OTHER

replace usual salt with potassium-enriched salt containing 25% potassium chloride

Usual salt

Participants will continue to use usual salt (≥99% sodium chloride) in the preparation of home meals.

Group Type PLACEBO_COMPARATOR

Usual salt

Intervention Type OTHER

Usual salt (NaCl \>99%)

Interventions

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Potassium-enriched salt substitute

replace usual salt with potassium-enriched salt containing 25% potassium chloride

Intervention Type OTHER

Usual salt

Usual salt (NaCl \>99%)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Singleton pregnancy with a viable fetus at ≤16 weeks of gestation.
2. Meets at least one of the following criteria (enrolled sequentially):

1. Systolic Blood Pressure (SBP) ≥130 mmHg and \<160 mmHg at enrollment, OR current monotherapy with antihypertensive medications such as labetalol or nifedipine (priority enrollment).
2. At least one of the following 4 items: advanced maternal age (≥35 years), pre-pregnancy obesity (BMI ≥28 kg/m²), history of preeclampsia, or pre-existing type 1 or type 2 diabetes.
3. At least two of the following 5 items: history of adverse pregnancy outcome (e.g., fetal death, placental abruption, fetal growth restriction), personal history of gestational hypertension or family history of preeclampsia (mother or sister), history of gestational diabetes, obstructive sleep apnea, or pre-pregnancy overweight (BMI 24-28 kg/m²).
3. Routinely eats at least two meals per day at home (including meals brought from home).
4. Able to attend regular antenatal check-ups and is expected to complete the study follow-up.
5. Provides written informed consent. -

Exclusion Criteria

1. SBP ≥160 mmHg or Diastolic Blood Pressure (DBP) ≥110 mmHg at enrollment.
2. Conditions or history associated with high uterine tension (e.g., polyhydramnios, macrosomia, hydatidiform mole); autoimmune diseases (e.g., systemic lupus erythematosus, antiphospholipid syndrome).
3. History of chronic kidney disease, OR any antenatal check-up with a confirmed estimated Glomerular Filtration Rate (eGFR) \<70 ml/min/1.73m², OR dipstick urine protein ≥2+.
4. Diagnosed hyperkalemia.
5. History of hypotension or syncope.
6. A household member who shares meals has a confirmed diagnosis of chronic kidney disease or hyperkalemia.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Peking University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jie Qiao

Role: PRINCIPAL_INVESTIGATOR

Peking University

Yangfeng Wu

Role: PRINCIPAL_INVESTIGATOR

Peking University

Locations

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Chongqing Bishan District Maternal and Child Health Care Hospital

Bishan, Chongqing Municipality, China

Site Status

Chongqing Fuling District Maternal and Child Health Care Hospital

Fuling, Chongqing Municipality, China

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Chongqing Qijiang District People's Hospital

Gunan, Chongqing Municipality, China

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Chongqing Hechuan District Maternal and Child Health Care Hospital

Hechuan, Chongqing Municipality, China

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Chongqing Jiangjin District Maternal and Child Health Care Hospital

Jiangjin, Chongqing Municipality, China

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Chongqing Qianjiang District Maternal and Child Health Care Hospital

Qianjiang, Chongqing Municipality, China

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The First Affiliated Hospital of Army Medical University (Xinan Hospital)

Shapingba, Chongqing Municipality, China

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The Second Affiliated Hospital of Army Medical University (Xinqiao Hospital)

Shapingba, Chongqing Municipality, China

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University Town Hospital of Chongqing Medical University

Shapingba, Chongqing Municipality, China

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Chongqing Wulong District Maternal and Child Health Care Hospital

Wulong, Chongqing Municipality, China

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Chongqing Wushan County People's Hospital

Wushan, Chongqing Municipality, China

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Chongqing Yongchuan District Maternal and Child Health Care Hospital

Yongchuan, Chongqing Municipality, China

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Chongqing Maternal and Child Health Care Hospital

Yubei, Chongqing Municipality, China

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Chongqing Yubei District Maternal and Child Health Care Hospital

Yubei, Chongqing Municipality, China

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Chongqing Yunyang County People's Hospital

Yunyang, Chongqing Municipality, China

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Army Specialty Medical Center (Daping Hospital)

Yuzhong, Chongqing Municipality, China

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The First Affiliated Hospital of Chongqing Medical University

Yuzhong, Chongqing Municipality, China

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The Second Affiliated Hospital of Chongqing Medical University

Yuzhong, Chongqing Municipality, China

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Affiliated Hospital of Hebei University

Baoding, Hebei, China

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Baoding Maternal and Child Health Hospital

Baoding, Hebei, China

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Yixian Maternal and Child Health Hospital

Baoding, Hebei, China

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Cangzhou Central Hospital

Cangzhou, Hebei, China

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Cangzhou Maternal and Child Health Hospital

Cangzhou, Hebei, China

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Huanghua People's Hospital

Cangzhou, Hebei, China

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Gucheng County Hospital

Hengshui, Hebei, China

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Hengshui Fourth Hospital

Hengshui, Hebei, China

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Hengshui Maternal and Child Health Care Hospital

Hengshui, Hebei, China

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China Petroleum Central Hospital (Hebei)

Langfang, Hebei, China

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Hebei Yanda Hospital

Langfang, Hebei, China

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Langfang People's Hospital

Langfang, Hebei, China

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Qinhuangdao Changli County Maternal and Child Health Hospital

Qinhuangdao, Hebei, China

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Qinhuangdao Maternal and Child Health Hospital

Qinhuangdao, Hebei, China

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Qinhuangdao Qinglong County People's Hospital

Qinhuangdao, Hebei, China

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Shijiazhuang Maternity & Child Healthcare Hospital

Shijiazhuang, Hebei, China

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Xinle City Hospital

Shijiazhuang, Hebei, China

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Linxi County People's Hospital

Xingtai, Hebei, China

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Weixian County People's Hospital

Xingtai, Hebei, China

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Xingtai People's Hospital

Xingtai, Hebei, China

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Guyuan Maternal and Child Health Care Hospital

Guyuan, Ningxia, China

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Guyuan People's Hospital

Guyuan, Ningxia, China

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Lingwu People's Hospital

Lingwu, Ningxia, China

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Pingluo County People's Hospital

Pingluo Chengguanzhen, Ningxia, China

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Shizuishan First People's Hospital

Shizuishan, Ningxia, China

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Wuzhong People's Hospital

Wuzhong, Ningxia, China

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Ningxia Hui Autonomous Region Hospital of Traditional Chinese Medicine

Xixia, Ningxia, China

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Ningxia Hui Autonomous Region People's Hospital

Yinchuan, Ningxia, China

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Peking University First Hospital Ningxia Women and Children's Hospital

Yinchuan, Ningxia, China

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Yinchuan First People's Hospital

Yinchuan, Ningxia, China

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Yinchuan Maternal and Child Health Care Hospital

Yinchuan, Ningxia, China

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Tongxin County People's Hospital

Yuhai, Ningxia, China

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Zhongning County People's Hospital

Zhongwei, Ningxia, China

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Zhongwei People's Hospital

Zhongwei, Ningxia, China

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Binzhou Medical University Hospital

Binzhou, Shandong, China

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Qilu Hospital of Shandong University (Dezhou Hospital)

Dezhou, Shandong, China

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Dongying Second People's Hospital

Dongying, Shandong, China

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Dong'e County People's Hospital

Dong’e, Shandong, China

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Feicheng People's Hospital

Feicheng, Shandong, China

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Heze Municipal Hospital

Heze, Shandong, China

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Jinan Maternal and Child Health Care Hospital

Jinan, Shandong, China

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Qilu Hospital of Shandong University

Jinan, Shandong, China

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Shandong Provincial Hospital

Jinan, Shandong, China

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Shandong Provincial Maternal and Child Health Care Hospital

Jinan, Shandong, China

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The First Affiliated Hospital of Shandong First Medical University (Qianfoshan Hospital)

Jinan, Shandong, China

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The Second Hospital of Shandong University

Jinan, Shandong, China

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The Second Jinan Maternal and Child Health Care Hospital

Jinan, Shandong, China

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Jining First People's Hospital

Jining, Shandong, China

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The Affiliated Hospital of Jining Medical University

Jining, Shandong, China

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Laizhou Maternal and Child Health Hospital

Laizhou, Shandong, China

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Lanling County People's Hospital

Lanling, Shandong, China

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Liaocheng People's Hospital

Liaocheng, Shandong, China

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Linyi People's Hospital

Linyi, Shandong, China

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Qingdao Chengyang District People's Hospital

Qingdao, Shandong, China

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Qingdao Women and Children's Hospital (Peking University People's Hospital Qingdao Branch)

Qingdao, Shandong, China

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Rizhao People's Hospital

Rizhao, Shandong, China

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Taian Central Hospital

Taian, Shandong, China

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Weifang Maternal and Child Health Hospital

Weifang, Shandong, China

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Weihai Maternal and Child Health Hospital

Weihai, Shandong, China

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Yantai Yeda Hospital

Yantai, Shandong, China

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Yantai Yuhuangding Hospital

Yantai, Shandong, China

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Rongcheng Maternal and Child Health Hospital

Yatou, Shandong, China

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Zaozhuang Maternal and Child Health Hospital

Zaozhuang, Shandong, China

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Huantai County Maternal and Child Health Hospital

Zibo, Shandong, China

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Zibo Maternal and Child Health Hospital

Zibo, Shandong, China

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Zoucheng People's Hospital

Zoucheng, Shandong, China

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Zouping People's Hospital

Zouping, Shandong, China

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Xinjiang Military Region General Hospital

Ürümqi, Xingjiang, China

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The First People's Hospital of Aksu Prefecture

Aksu, Xinjiang, China

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Altay Prefecture People's Hospital

Altay, Xinjiang, China

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Kizilsu Kirgiz Autonomous Prefecture People's Hospital

Artux, Xinjiang, China

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Bortala Mongolian Autonomous Prefecture People's Hospital

Bole, Xinjiang, China

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Changji Hui Autonomous Prefecture People's Hospital

Changji, Xinjiang, China

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The First Affiliated Hospital of Xinjiang Medical University (Changji Branch)

Changji, Xinjiang, China

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Hami Central Hospital

Hami, Xinjiang, China

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Hotan Prefecture People's Hospital

Hotan, Xinjiang, China

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Karamay Central Hospital

Karamay, Xinjiang, China

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The First People's Hospital of Kashi

Kashgar, Xinjiang, China

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The Second People's Hospital of Kashi Prefecture

Kashgar, Xinjiang, China

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Bayingolin Mongolian Autonomous Prefecture People's Hospital

Korla, Xinjiang, China

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The First Affiliated Hospital of Shihezi University

Shihezi, Xinjiang, China

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Turpan Gaochang District People's Hospital

Turpan, Xinjiang, China

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Turpan People's Hospital

Turpan, Xinjiang, China

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People's Hospital of Xinjiang Uygur Autonomous Region

Ürümqi, Xinjiang, China

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The First Affiliated Hospital of Xinjiang Medical University

Ürümqi, Xinjiang, China

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Urumqi First People's Hospital (Railway Bureau Campus)

Ürümqi, Xinjiang, China

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Urumqi Maternal and Child Health Care Hospital (Urumqi You'ai Hospital)

Ürümqi, Xinjiang, China

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Yili Prefecture Friendship Hospital

Yining, Xinjiang, China

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Chongqing Wanzhou District Maternal and Child Health Care Hospital

Wanzhou, , China

Site Status

Countries

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China

Central Contacts

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Yifang Yuan

Role: CONTACT

Phone: 0086-17310387323

Email: [email protected]

Jie Yuan

Role: CONTACT

Phone: 0086-15222768336

Email: [email protected]

Facility Contacts

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Li Liu

Role: primary

Xuejuan Xiao

Role: primary

Xiaojun Wang

Role: primary

Chongwen Xia

Role: primary

Zhaoning Ding

Role: primary

Min Huang

Role: primary

Dan Wang

Role: primary

Zhengqiong Chen

Role: primary

Jing Tian

Role: primary

Xianmei Li

Role: primary

Laqiong Tan

Role: primary

Li Luo

Role: primary

Lan Wang

Role: primary

Xian Che

Role: primary

Hong Tang

Role: primary

Xiuhui Zheng

Role: primary

Xin Luo

Role: primary

Yingya Xu

Role: primary

Hongli Zhang

Role: primary

Jing Zhang

Role: primary

Jianxue Gao

Role: primary

Dandan Shi

Role: primary

Xinyan Wang

Role: primary

Jing Zhang

Role: primary

Fang Liu

Role: primary

Chunyan Wang

Role: primary

Lihua Bai

Role: primary

Zhimin Gao

Role: primary

Zhenyan Wang

Role: primary

Jing Zhang

Role: primary

Jing Wang

Role: primary

Chunyu Zhang

Role: primary

Li Tong

Role: primary

Lulu Sun

Role: primary

Yuxia Guo

Role: primary

Guizhen Dou

Role: primary

Juncai Guo

Role: primary

Zongxu Qiao

Role: primary

Lin Hu

Role: primary

Liping Liu

Role: primary

Wenhua Zhang

Role: primary

Jinmei Wang

Role: primary

Ling Zhang

Role: primary

Tao Wang

Role: primary

Lifang Li

Role: primary

Yang Fan

Role: primary

Ling He

Role: primary

Xin Qi

Role: primary

Yingchun Ha

Role: primary

Jinlian Ma

Role: primary

Jianping Li

Role: primary

Lihua Wang

Role: primary

Kexin Lu

Role: primary

Peng Yu

Role: primary

Caixia Zhou

Role: primary

Yan Jiang

Role: primary

Qiuyun Guo

Role: primary

Cuili Zou

Role: primary

Fengchun Gao

Role: primary

Xia Luo

Role: primary

Xietong Wang

Role: primary

Yan Lian

Role: primary

Wei Guo

Role: primary

Fanzhen Hong

Role: primary

Yan Wu

Role: primary

Yingjie Han

Role: primary

Dongmei Man

Role: primary

Xuxia Wu

Role: primary

Wenhui Sun

Role: primary

Xiaobing Wang

Role: primary

Ying Chen

Role: primary

Jinli Liang

Role: primary

Dongmei Fan

Role: primary

Yongjing Lai

Role: primary

Ling Huang

Role: primary

Yong Guo

Role: primary

Qiongqiong Wu

Role: primary

Xiangna Wan

Role: primary

Hongmei Qu

Role: primary

Hailing Yu

Role: primary

Chengwen Liu

Role: primary

Caiqin Jin

Role: primary

Yingchun Yu

Role: primary

Qi Chen

Role: primary

Shujian Xing

Role: primary

Zerong Tu

Role: primary

Kebinuer Maimaiti

Role: primary

Huimei Tian

Role: primary

Xinxin Zhang

Role: primary

Yonghui Dai

Role: primary

Weiwei Li

Role: primary

Ping Li

Role: primary

Yan Ma

Role: primary

Maihebureti Maimaitinuer

Role: primary

Jing Lv

Role: primary

Maihefuzaimu Abudukade

Role: primary

Baharguli Abulaiti

Role: primary

Hui Zhao

Role: primary

Yajuan Gu

Role: primary

Xue Xia

Role: primary

Juan Li

Role: primary

Ying Huang

Role: primary

Qiying Zhu

Role: primary

Lei Dai

Role: primary

Li Yan

Role: primary

Zonglin Lu

Role: primary

Xianbing Wang

Role: primary

Other Identifiers

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XMHEJH-WU

Identifier Type: -

Identifier Source: org_study_id