MATCOBIND: A Comparison of Two Different Doses of Maternal B12 Supplementation in Improving Infant B12 Deficiency and Neurodevelopment

• Sponsor: Sitaram Bhartia Institute of Science and Research (Other)
• Overall Status: Active, not recruiting
• CT.gov ID: NCT04083560
• Collaborator: Public Health Foundation of India (Other), Paropakar Matenity and Women's Hospital, Kathmandu, Nepal (Other), University College, London (Other)
• Enrollment: 708
• Locations: 2
• Arms: 2
• Anticipated Duration (Months): 48
• Patients Per Site: 354
• Patients Per Site Per Month: 7.4

Study Details

Study Description

Brief Summary

Supplementation with Iron and folate have been part of a worldwide strategy targeting anaemia and neural tube defects for many years. However, vitamin B12 deficiency has received much less attention. High prevalence of deficiency in mothers in the antenatal period and in their infants, has been documented. Multiple case series document the neurological consequences of severe deficiency and their reversal with B-12. Trials on the subject are limited and those available have either used an ineffective dose or for a short duration.

Therefore, we propose this randomised controlled trial to compare the efficacy of two different doses (pharmacological and preventive) of maternal Vitamin B-12 supplementation in improving infant B12 deficiency and neurodevelopment. We propose to undertake a multi-centric trial in India and Nepal given the high prevalence of deficiency reported from these countries and to allow a wider socio-demographic spectrum (Pay-for-service hospital catering to middle income populace from India and a free-care public hospital catering to lower income groups from Nepal). We will recruit 720 vegetarian, pregnant women from the antenatal clinics of the Indian and Nepalese centres at their first antenatal visit. Elderly primi mothers, taking B12 supplementation, multiple gestations, chronic medical conditions, anticipating moving out of the city, treated for infertility or with known psychological illnesses will be excluded. In Stage 1, recruited mothers will be randomized into 2 equal groups (360 each). Group 1-Daily 250 μg Vitamin B12 supplementation. Group 2-Daily 50 μg Vitamin B12 supplementation. B-12 will be started in 1st trimester and continue up to 6 months post-partum. In Stage 2, the birth and post-delivery course of the new-born will be monitored and documented for any morbidity. At 9 months, the neurodevelopmental, complementary feeding and home environment will be assessed and infant B12 status will be determined.

The two groups will be compared for the primary (neurodevelopment) and secondary outcomes (biochemical parameters in mother and infant). The results of this study will be used to generate scientific evidence on whether B-12 should be supplemented in vegetarian pregnant women with a view to preventing B-12 deficiency and its neurodevelopmental consequences in the infant.

Condition or Disease	Intervention/Treatment	Phase
Vitamin B 12 Deficiency	Drug: Vit B12	N/A

Study Design

• Study Type: Interventional
• Actual Enrollment: 708 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
• Primary Purpose: Prevention
• Official Title: A Comparison of Two Different Doses of Maternal B12 Supplementation in Improving Infant B12 Deficiency and Neurodevelopment
• Actual Study Start Date: Sep 26, 2018
• Anticipated Primary Completion Date: Sep 25, 2022
• Anticipated Study Completion Date: Sep 25, 2022

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Intervention group Group A Intervention: 360 pregnant women will receive 250 mcg of B-12 daily orally from 1st trimester to 6 months postpartum	Drug: Vit B12; Vitamin B12 250mcg
Active Comparator: Control group Group B- Control: 360 pregnant women will receive 50 mcg of B-12 daily orally from 1st trimester to 6 months post partum	Drug: Vit B12; Vitamin B12 250mcg

Outcome Measures

Primary Outcome Measures

1. Infant neurodevelopment [9 Month of infant age]

   Developmental Assessment Scale for Indian Infant (modified Bayleys scale) measured as average of motor and mental scores

Secondary Outcome Measures

1. Biochemical B12 status of mother [At recruitment]

   Change in B12 status of mother between first and third trimester

2. Biochemical B12 status of infant [9 months of infant age]

   Biochemical B12 status of infant at nine months postpartum

Other Outcome Measures

1. Mean Haemoglobin of infants [9 months of infant age]

   Haemoglobin of infants in grams per deciliter

2. Infant weight [9 months of infant age]

   Infant weight in kilograms

3. Infant length [9 months of infant age]

   Infant Length in cms

4. Infant head circumference [9 months of infant age]

   Infant Head circumference in cms

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years to 35 Years
• Sexes Eligible for Study: Female
• Accepts Healthy Volunteers: Yes

Inclusion Criteria:

• <12 weeks gestation

Vegetarian mothers

Exclusion Criteria:

1. Mothers already on B12 supplementation

2. Women with multiple gestation, those diagnosed with chronic medical conditions (diabetes mellitus, hypertension, heart disease, neurological disease or thyroid disease), and those who tested positive for hepatitis B, HIV or syphilis (associated with prematurity, IUGR and other neonatal morbidities which could influence neurodevelopment)

3. Women who anticipate moving out of the city before/ after delivery

4. Women treated for infertility

5. Women with known psychological illnesses including depression

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Sitaram Bhartia Institute of Science and Research	New Delhi	Delhi	India	110016
2	Rajendra Pant	Kathmandu		Nepal

Sponsors and Collaborators

• Sitaram Bhartia Institute of Science and Research
• Public Health Foundation of India
• Paropakar Matenity and Women's Hospital, Kathmandu, Nepal
• University College, London

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

• Responsible Party: Dr Jitender Nagpal, Senior Consultant and Head of the Department, Sitaram Bhartia Institute of Science and Research
• ClinicalTrials.gov Identifier: NCT04083560
• Other Study ID Numbers: MATCOBIND 2018
• First Posted: Sep 10, 2019
• Last Update Posted: May 4, 2022
• Last Verified: May 1, 2022

• Individual Participant Data (IPD) Sharing Statement: No
• Plan to Share IPD: No
• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No
• Additional relevant MeSH terms: Vitamin B 12 Deficiency; Hydroxocobalamin; Vitamin B 12

Study Results

No Results Posted as of May 4, 2022