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NCT Number: NCT05005897

Early Infant Micronutrition and Development

Globally, vitamin B12 deficiency is one of the most common micronutrient deficiencies. Poor status is also seen in affluent countries such as in Norway. Vitamin B12 is crucial for normal cell division and differentiation and necessary for the development and myelination of the central nervous system. Deficiency is also associated with impaired fetal and infant growth. In the proposed study we will measure the effect of daily oral vitamin B12 supplementation infants on neurodevelopment. We also aim to measure the impact of B12 supplementation on several other outcomes.

Study design: Individually randomized double-blind placebo-controlled trial breastfed infants who will be assigned to a screening group (in which measurements will be obtained immediately) or a control group (in which serum will be stored and measurements done after one year).

Pregnant women will be informed about the study during their first antenatal visit at the clinic and that we will re-approach them on their 6-week visit to their public health nurse. Infants who are deficient will be treated with peroral or intramuscular injections with 400 µg cyano-cobalamin.

Infants in the control group will not be offered any intervention their blood sample will be stored for one year and then analyzed for the same nutrients as the intervention group.

Outcomes: Primary: (i) neurodevelopment in children measured at 12 months of age (ii) growth in children measured by attained weight and length at 12 months. Secondary: (i) neurodevelopment and cognitive functioning in children later in life

Recruiting

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Key information

Age range

1 month–2 month

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2 / Phase 3

Primary location

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Availability of informed verbal consent
  • Plan to reside in the defined study area for the next 12 months
  • Mothers intend to breastfeed their children for at least 8 months, and exclusively for 4 months

Exclusion criteria

  • Severe systemic illness requiring hospitalization
  • Growth retardation
  • Severe congenital malformations
  • Plasma cobalamin concentration <148 pmol/L (These children will be treated for vitamin B12 deficiency and not included in the RCT, but will be included in the cohort design)

Treatment and study plan

Cyanocobalamin

Biological

Intramuscular injection of 400 µg cobalamin to children with elevated thcy at enrollment

Other names: Vitamin B12

Primary outcomes

  1. Neurodevelopment

    Time frame: 12 months of age

    Bayley Scales of Infant Development 4th edition

  2. Prevalence of vitamin B12 deficiency

    Time frame: 1-3 months of age

    Number of children with elevated plasma homocysteine or low cobalamin

  3. Prevalence of other vitamin deficiencies

    Time frame: 1-3 months of age

    Number of infants with vitamin deficiencies other than vitamin B12 deficiency

Secondary outcomes

  1. Neurodevelopment measured by the Ages and Stages Questionaire

    Time frame: 4-12 months of age

    Ages and Stages Questionnaire version 3 repeated throughout infancy

  2. Vagal tone

    Time frame: 12 months of age

    Heart rate variability

  3. Eye tracking

    Time frame: 12 months of age

    Visual acuity, visuospatial orientation, and attention to social cues

  4. Neurodevelopment later in childhood

    Time frame: 5 years

    General cognitive abilities ("IQ") assessed by the Wechsler Preschool and Primary Scale of Intelligence

  5. Adverse events

    Time frame: 3 months after treatment with vitamin B12

    Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

Other outcomes

  1. Thyroid function

    Time frame: 12 months of age

    Infant thyroid function measured by the concentration of the hormones TSH, T3, and T4

Study contacts

Contact information is provided by the study sponsor or research team.

Carolien Konijnenberg, Ph.D

CONTACT

[email protected]

+47 61 28 74 94

Kjersti S Bakken, Ph.D.

CONTACT

[email protected]

+47 957 81 349

Sponsors and collaborators

Lead sponsor

Sykehuset Innlandet HF

Other

Collaborators

  • Inland Norway University of Applied Sciences
  • University of Bergen
  • University of Oslo

Registry information

Official study title

Vitamin B12 Status in Infancy and the Effect of Providing Vitamin B12 to Infants With Signs of Suboptimal Vitamin B12 Status - a Registry-based, Randomized Controlled Trial

Acronym: RART

Important dates

Study start
2021
Primary completion
2025
Study completion
2029
First posted
Aug 16, 2021
Registry last updated
Apr 18, 2023

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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