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Completed

NCT Number: NCT04438928

Clinical Study on the Effect of Elevit Pregnancy 2nd & 3rd Trimester (Multi-micronutrients & DHA Supplement) on the Nutritional Status of Pregnant Women During Second and Third Trimester

The aim of this study is to collect information how adding a soft gel preparation of micronutrients such as vitamins, dietary minerals plus omega-3 fatty acid (docosahexaenoic acid, DHA) to the diet of pregnant women during the 2nd and 3rd trimesters of pregnancy effects the nutritional state of the mother and infants at delivery.

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Key information

Age range

18 year–42 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

ASST Fatebenefratelli Sacco, Milan, Lombardy, Italy

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Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Healthy pregnant Caucasian women aged 18 to 42 years (inclusive) in their 1st - 2nd trimester (gestational age (GA) week 11-14 at screening);
  • Hemoglobin (Hg) > 105g/L;
  • Inconspicuous fetal anomaly screening;
  • Normal ultrasound examination (Ultra Sonography (USG));
  • Singleton pregnancy;
  • Taking at least 400 mcg folate per day;
  • Seronegative for Human Immunodeficiency Virus (HIV), Hepatitis B and Hepatitis C at screening;
  • Pregnant women who, in the opinion of the Investigator, are willing and able to participate in all scheduled visits, to adhere to the supplementation plan, to laboratory tests and to all other study related procedures according to the clinical protocol;
  • Pregnant women providing a personally signed and dated given informed consent to participate in the study and to adhere to all study procedures indicating that they have been informed of all pertinent aspects of the trial and that they understood and accepted these, prior to admission to the study.

Exclusion criteria

  • Physical (including vital signs e.g. blood pressure and pulse rate), hematological and clinical-chemical parameters deviating from normal and with clinical relevance;
  • Any infection (acute or chronic) at screening and baseline;
  • Any current metabolic diseases (e.g. diabetes, hypothyroidism);
  • Less than 12 months from previous delivery;
  • Any history or current diseases, which are associated with malabsorption, or other severe diseases of the gastrointestinal tract (e.g. chronic inflammatory bowel disease, iron accumulation, iron utilization disorders); Any history or current neurological, cardiac, endocrine or bleeding disorders;
  • Specific diets (e.g. vegan vegetarian, celiac, lactose free);
  • Body mass index (BMI) < 18 or >30 kg/m2;
  • Pregnant women already taking DHA/multivitamin supplements (except folate or iron);
  • Diagnosed or suspected malignant or premalignant disease;
  • Current clinically significant depression;
  • Current intake of pharmaceuticals or dietary supplements which may interact with any of the ingredients of the trial treatment (i.e. fluoroquinolones, bisphosphonates, levodopa, levothyroxine, penicillamine, antibiotics containing tetracycline or trietine);
  • History of or current diseases where vitamin, mineral, trace element or DHA supplementation might be not recommended /contraindicated [such as sickle cell anemia, copper metabolism disorders (Wilson's disease), renal disease, nephrolithiasis, urolithiasis, hypercalcemia, hypercalciuria, hepatobiliary diseases, existing hypervitaminosis, iron metabolism disorders, hypermagnesemia];
  • Severe Hyperemesis gravidarum;
  • Previous adverse birth outcomes (e.g. small for gestational age, low birth weight, premature birth, stillbirth, more than two consecutive spontaneous abortions);
  • Previous adverse pregnancy outcomes (e.g. gestational diabetes);
  • Diagnosed congenital abnormalities in current or previous pregnancy;
  • Known carrier or affected with a genetic disease or condition (e.g. mutation carrier for autosomal recessive diseases);
  • History of or current abuse of drugs, alcohol or other substances;
  • Current smokers and women who smoked during current pregnancy;
  • Any history of hypersensitivity or known allergy to any of the ingredients of the study supplement.

Treatment and study plan

Elevit Pregnancy 2nd & 3rd Trimester

Dietary Supplement

Once daily micronutrient plus DHA supplementation (Multi-micronutrients and docosahexaenoic acid (MMS) soft gel capsules)

Other names: BAY 987765 Multi-micronutrient & DHA

Non-Supplement

Other

Control study group of pregnant women non-supplemented with multi-micronutrients and docosahexaenoic acid (MMS) soft gel capsules

Primary outcomes

  1. Change from baseline: Blood RBC DHA/wt% TFA

    Time frame: Baseline: Screening at gestational age (GA) week 11 to 13 and at GA week 24 to 26 and week 34 to 36

    In order to assess the beneficial effects of supplementation with micronutrients and DHA (docosahexaenoic acid) during 2nd and 3rd trimesters of pregnancy, the red blood cell (RBC) DHA weight percent of total fatty acids (DHA wt% TFA) will be measured compared to baseline as primary maternal variable.

    Gestational age is a measure of the age of a pregnancy which is taken from the beginning of the woman's last menstrual period (LMP), or the corresponding age of the gestation as estimated by a more accurate method if available. Such methods include adding 14 days to a known duration since fertilization (as is possible in in vitro fertilization), or by obstetric ultrasonography. The popularity of using such a definition of gestational age is that menstrual periods are essentially always noticed, while there is usually a lack of a convenient way to discern when fertilization occurred.

Secondary outcomes

  1. Change from baseline: Blood RBC EPA/wt% TFA

    Time frame: Baseline: Screening at gestational age (GA) week 11 to 13 and at GA week 24 to 26 and week 34 to 36

    Red blood cell (RBC) EPA (eicosapentaenoic acid) weight percent of total fatty acids (DHA wt% TFA).

  2. Change from baseline: Blood RBC DHA/TFA ratio %

    Time frame: Baseline: Screening at gestational age (GA) week 11 to 13 and at GA week 24 to 26 and week 34 to 36

  3. Change from baseline: Blood RBC Omega 3 index in RBC

    Time frame: Baseline: Screening at gestational age (GA) week 11 to 13 and at GA week 24 to 26 and week 34 to 36

    The "omega-3 index" reflects the content of EPA plus DHA in erythrocyte membranes expressed as a percentage of total erythrocyte fatty acids.

  4. Change from baseline: Blood 25-hydroxyvitamin D concentration %

    Time frame: Baseline: Screening at gestational age (GA) week 11 to 13 and at GA week 24 to 26 and week 34 to 36

  5. Change from baseline: Blood Glutathione (GSH)/oxidized Glutathione (GSSG) ratio %

    Time frame: Baseline: Screening at gestational age (GA) week 11 to 13 and at GA week 24 to 26 and week 34 to 36

    Glutathione exists in reduced (GSH) and oxidized (GSSG) states. Reduced glutathione is the most abundant antioxidant in aerobic cells and participates in the detoxification of lipid hydroperoxides and hydrogen peroxide exerted by glutathione peroxidases. When cells are exposes to increased oxidative stress levels, GSSG accumulates and the GSH/GSSG ratio decreases.

  6. Change from baseline: Blood Reactive oxygen metabolites (ROMs) concentrations %

    Time frame: Baseline: Screening at gestational age (GA) week 11 to 13 and at GA week 24 to 26 and week 34 to 36

  7. Change from baseline: Blood 8-Isoprostane concentration %

    Time frame: Baseline: Screening at gestational age (GA) week 11 to 13 and at GA week 24 to 26 and week 34 to 36

  8. Infant sex

    Time frame: At delivery

  9. Infant gestational age

    Time frame: At delivery

  10. Infant head circumference

    Time frame: At delivery

  11. Infant weight measurements

    Time frame: At delivery

  12. Infant length measurements

    Time frame: At delivery

  13. Infant ponderal index

    Time frame: At delivery

  14. Infant skinfold thickness

    Time frame: At delivery

    Triplicate measurements: triceps, biceps, suprailiac, and subscapular on left side with standard skinfold caliper operated with constant pressure of 10 g/mm2)

  15. Infant Apgar score

    Time frame: At delivery

  16. Infant bone density

    Time frame: Up to 10 days after delivery

  17. Umbilical cord blood gas analysis

    Time frame: At delivery

    Cord blood sample evaluations in a subset of women undergoing Caesarean section.

  18. Umbilical cord blood pH analysis

    Time frame: At delivery

    Cord blood sample evaluations in a subset of women undergoing Caesarean section.

  19. Cord blood metabolomic analysis

    Time frame: At delivery

    Cord blood sample evaluations in a subset of women undergoing Caesarean section.

  20. Placental weight

    Time frame: At delivery

    Placenta tissue sample evaluation in a subset of women undergoing caesarean section.

    Placental efficiency will be estimated through the feto/placental weight (F/P) ratio, calculated as birth weight divided by the placental weight.

  21. Placental biometric parameters

    Time frame: At delivery

    Placenta tissue sample evaluation in a subset of women undergoing caesarean section.

    i.e. larger (D) and smaller (d) diameters of the chorionic elliptical disc, feto/placental weight (F/P ratio)

  22. Blood, cord blood and placental RBC DHA/wt% TFA

    Time frame: At delivery

    Sample evaluations in a subset of women undergoing Caesarean section.

  23. Blood, cord blood and placental RBC EPA wt% TFA

    Time frame: At delivery

    Sample evaluations in a subset of women undergoing Caesarean section.

  24. Blood, cord blood and placental DHA/TFA ratio %

    Time frame: At delivery

    Sample evaluations in a subset of women undergoing Caesarean section.

  25. Blood, cord blood and placental RBC Omega 3 index

    Time frame: At delivery

    Sample evaluations in a subset of women undergoing Caesarean section.

  26. Mitochondrial DNA content evaluation in placental tissue and isolated trophoblast cells

    Time frame: At delivery

    mtDNA is a well-accepted molecular marker to assess mitochondria content.

    Sample evaluations in a subset of women undergoing Caesarean section.

  27. IL-6 (Interleukin 6), IL-10 (Interleukin 10) and TNF-α (Tumor Necrosis Factor Alpha) in placental tissue and isolated trophoblast cells

    Time frame: At delivery

    These genes are constitutively expressed in human placenta and are a reliable marker of inflammation.

    Sample evaluations in a subset of women undergoing Caesarean section.

  28. Placental tissue metabolomic analysis

    Time frame: At delivery

    Sample evaluations in a subset of women undergoing Caesarean section.

    The rationale for conducting metabolomic analysis is to understand if multi-micronutrient supplement (MMS) supplementation during the second and third trimester of pregnancy influences maternal and infant gestational outcomes (e.g. oxidative stress, placental function).

  29. Blood, cord blood and placental 8-isoprostane

    Time frame: At delivery

    Sample evaluations in a subset of women undergoing Caesarean section.

  30. Blood, cord blood and placental reactive oxygen metabolites (ROMs) concentrations %

    Time frame: At delivery

    Sample evaluations in a subset of women undergoing Caesarean section.

  31. Number of Adverse Events (AEs)

    Time frame: Within 7 days after Delivery

  32. Severity of AEs

    Time frame: Within 7 days after Delivery

  33. AE relationship to the investigational product

    Time frame: Within 7 days after Delivery

Other outcomes

  1. Maternal Food Frequency Questionnaire FFQ

    Time frame: Up to GA week 34-36

    Focus on foods providing DHA

Sponsors and collaborators

Lead sponsor

Bayer

Industry

Registry information

Official study title

Effects of Multiple Micronutrients and Docosahexaenoic Acid (DHA) Supplementation During Pregnancy on Maternal Biomarkers and Infant Anthropometric Outcomes

Important dates

Study start
2016
Primary completion
2019
Study completion
2019
First posted
Jun 19, 2020
Registry last updated
Nov 16, 2020

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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