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Infant MortalityPhase 3JiVitA-3NCT00860470

Antenatal Micronutrient Supplementation and Infant Survival

A Phase 3 study testing Iron (27 mg) - folic acid (600 ug) and Multiple micronutrient in people with Infant Mortality and Preterm Birth, run by Johns Hopkins Bloomberg School of Public Health at 2 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this community-based randomized trial is to examine whether a daily antenatal and postnatal multiple micronutrient supplement given to women will enhance newborn and infant survival and health and other birth outcomes in a rural setting in northwestern Bangladesh. Read more about this study

Who is it for?
Ages 12 to 45 years, women onlyHealthy volunteers can take part
Conditions the study is for
Infant Mortality, Preterm Birth, Low Birth Weight
What is being tested?
Iron (27 mg) - folic acid (600 ug) and Multiple micronutrient
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
44,567 participants
Where
2 sitesin 2 countries
Study dates
Jan 2008to Sep 2012
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 12 to 45 years
  • Women only
  • Healthy volunteers accepted
  • Child, Adult

Who may be able to join

  • Pregnant and consents to participate

Who cannot join

  • Not interviewed for consent within 12 consecutive weeks after being ascertained as pregnant by urine testing

Trial locations and contacts

2 sites in 2 countries.

2 sites in 2 countries

United States1 site
  • Johns Hopkins School of Public Health

    Baltimore, Maryland, 21205

Other trials in United States

Bangladesh1 site
  • JiVitA Project Office

    Rangpur City, Gaibandha District

Other trials in Bangladesh

About this study

Official title: Antenatal Multiple Micronutrient Supplementation to Improve Infant Survival and Health in Bangladesh

The purpose of this community-based randomized trial is to examine whether a daily antenatal and postnatal multiple micronutrient supplement given to women will enhance newborn and infant survival and health and other birth outcomes in a rural setting in northwestern Bangladesh.

Read the detailed description

Maternal deficiency in multiple essential micronutrients is likely to be a major public health problem in low-income countries. Supplementing mothers with certain individual micronutrients has been shown to confer health benefits, although the evidence is not clear for multiple micronutrients. We aim to test, in a cluster-randomized, double-masked, controlled trial whether giving a daily multiple micronutrient supplement (similar in composition to the UNICEF antenatal supplement) will enhance infant survival and birth outcomes such as birth weight and gestational duration in a rural population in Bangladesh. Over the duration of 2-3 years a community-surveillance in the northwestern, rural Districts of Gaibandha and Southern Rangpur, the trial plans to identify and recruit 45,000 pregnant women based on 5-weekly histories of amenorrhea confirmed by urine-testing, and supplement them with either a multiple micronutrient supplement or an iron-folic acid supplement (as the standard of care control for pregnancy) and monitor pregnancy health, birth outcomes and vital status and health of liveborn infants through 6 months of age. In a ~3% sub-sample of mothers, additional measures of nutritional and health status will be evaluated in the 1st and 3rd trimesters of pregnancy, and at 3 months postpartum (with infants), that include anthropometric and body composition (bioelectrical impedance) assessment, collection of biospecimens (eg, phlebotomy and breast milk sampling for micronutrient and other analyte concentration determinations), and other clinical assessments. The trial will generate evidence from which to examine the safety and efficacy of an antenatal through postnatal maternal micronutrient supplement intervention in order to inform and guide antenatal nutrition policies and programs in South Asia.

Being tested
Iron (27 mg) - folic acid (600 ug), Multiple micronutrient
Keywords
micronutrients, deficiency, pregnancy, birth outcomes, infant mortality, neonatal mortality, malnutrition, antenatal
Medical subject headings
Infant Death, Premature Birth, Perinatal Death, Malnutrition

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Iron (27 mg) - folic acid (600 ug)Dietary supplement

    Also called iron-folate

    Supplement serves as the "Control" (providing the current standard of care during pregnancy). Mothers instructed to take 1 tablet per day, from the 1st trimester through 12 weeks post-partum.

  • Multiple micronutrientDietary supplement

    Also called one-a-day multivitamin, antenatal micronutrient

    Containing 15 micronutrients all at an RDA including: vitamin A (770 ug retinol equivalents, vitamin D (5 ug), vitamin E (15 mg), folic acid (600 ug), thiamin (1.4 mg), riboflavin (1.4 mg), niacin (18 mg), vitamin B-12 (2.6 mg), vitamin B-6 (1.9 mg), vitamin C (85 mg), iron (27 mg), zinc (12 mg), iodine (220 ug), copper (1000 ug), selenium (60 ug).

    Mothers instructed to take 1 tablet per day, from the 1st trimester through 12 weeks post-partum.

Study groups in NCT00860470
Study groupRoleWhat they receive
1Active comparatorIron (27 mg) and folic acid (600 ug)
Receives: Dietary Supplement: Iron (27 mg) - folic acid (600 ug)
2ExperimentalMultiple micronutrient
Receives: Dietary Supplement: Multiple micronutrient

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Infant Mortality Through 6 mo of Age

    Infant Mortality to Age 6 months (180 days from birth)

    Measured: 6-months post-birth

Secondary outcomes (9)
  1. Neonatal Mortality

    Neonatal Mortality (28 days of life)

    Measured: 1 month post-birth

  2. Post-neonatal Mortality

    Risk of Post-neonatal Mortality (29th -180th day of life)

    Measured: 1-6 months post-birth

  3. Still Birth Rates

    Stillbirth (born >=24 weeks without breathing, crying, or moving limbs).

    Measured: 24 weeks gestation to delivery

  4. Preterm Birth

    Being born before 37 weeks of gestation

    Measured: Up to 37 weeks of gestation

  5. Extremely Pre-term

    Birth before 28 weeks gestation

    Measured: Up to 28 weeks of gestation

  6. Very Pre-term

    Birth between 28 and 32 weeks of gestation

    Measured: Between 27 and 33 weeks of gestation

  7. Moderate to Late Preterm

    Birth between 32 and 37 weeks gestation

    Measured: Between 31 and 38 weeks of gestation

  8. Low Birth Weight

    Birth weight below 2500g

    Measured: Measured at delivery/birth

  9. Small for Gestation Age

    Small for Gestational Age defined as birth weight <10th percentile of a standard reference (Alexander GR, Himes JH, Kaufman RB, et al. Obstet Gynecol. 1996;87(2):163-68).

    Measured: At delivery/birth

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Mar 2009 (estimated)
  2. Study startJan 2008
  3. Primary completionSep 2012
  4. Study completionSep 2012

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
44,567 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00860470
Sponsor's protocol ID
JHU_IRB 570
Acronym
JiVitA-3
Status last verified
Oct 2022
First submitted
11 Mar 2009
Last updated
19 Oct 2022
Data monitoring committee
Yes

Publications

  • Christian P, Khatry SK, Katz J, Pradhan EK, LeClerq SC, Shrestha SR, Adhikari RK, Sommer A, West KP Jr. Effects of alternative maternal micronutrient supplements on low birth weight in rural Nepal: double blind randomised community trial. BMJ. 2003 Mar 15;326(7389):571. doi: 10.1136/bmj.326.7389.571.

    PubMed 12637400
  • Christian P. Micronutrients and reproductive health issues: an international perspective. J Nutr. 2003 Jun;133(6):1969S-1973S. doi: 10.1093/jn/133.6.1969S.

    PubMed 12771347
  • Christian P, Shrestha J, LeClerq SC, Khatry SK, Jiang T, Wagner T, Katz J, West KP Jr. Supplementation with micronutrients in addition to iron and folic acid does not further improve the hematologic status of pregnant women in rural Nepal. J Nutr. 2003 Nov;133(11):3492-8. doi: 10.1093/jn/133.11.3492.

    PubMed 14608063
  • Christian P, West KP, Khatry SK, Leclerq SC, Pradhan EK, Katz J, Shrestha SR, Sommer A. Effects of maternal micronutrient supplementation on fetal loss and infant mortality: a cluster-randomized trial in Nepal. Am J Clin Nutr. 2003 Dec;78(6):1194-202. doi: 10.1093/ajcn/78.6.1194.

    PubMed 14668283
  • Katz J, West KP Jr, Khatry SK, Christian P, LeClerq SC, Pradhan EK, Shrestha SR. Risk factors for early infant mortality in Sarlahi district, Nepal. Bull World Health Organ. 2003;81(10):717-25. Epub 2003 Nov 25.

    PubMed 14758431
  • Jiang T, Christian P, Khatry SK, Wu L, West KP Jr. Micronutrient deficiencies in early pregnancy are common, concurrent, and vary by season among rural Nepali pregnant women. J Nutr. 2005 May;135(5):1106-12. doi: 10.1093/jn/135.5.1106.

    PubMed 15867289
  • Christian P, Osrin D, Manandhar DS, Khatry SK, de L Costello AM, West KP Jr. Antenatal micronutrient supplements in Nepal. Lancet. 2005 Aug 27-Sep 2;366(9487):711-2. doi: 10.1016/S0140-6736(05)67166-8. No abstract available.

    PubMed 16125578
  • Christian P, Jiang T, Khatry SK, LeClerq SC, Shrestha SR, West KP Jr. Antenatal supplementation with micronutrients and biochemical indicators of status and subclinical infection in rural Nepal. Am J Clin Nutr. 2006 Apr;83(4):788-94. doi: 10.1093/ajcn/83.4.788.

    PubMed 16600929
  • Katz J, Christian P, Dominici F, Zeger SL. Treatment effects of maternal micronutrient supplementation vary by percentiles of the birth weight distribution in rural Nepal. J Nutr. 2006 May;136(5):1389-94. doi: 10.1093/jn/136.5.1389.

    PubMed 16614435
  • West KP Jr, Christian P. Antenatal micronutrients in undernourished people. Lancet. 2008 Feb 9;371(9611):452-4. doi: 10.1016/S0140-6736(08)60214-7. No abstract available.

    PubMed 18262025
  • Christian P, Darmstadt GL, Wu L, Khatry SK, Leclerq SC, Katz J, West KP Jr, Adhikari RK. The effect of maternal micronutrient supplementation on early neonatal morbidity in rural Nepal: a randomised, controlled, community trial. Arch Dis Child. 2008 Aug;93(8):660-4. doi: 10.1136/adc.2006.114009.

    PubMed 18644934
  • Shankar AH, Genton B, Baisor M, Paino J, Tamja S, Adiguma T, Wu L, Rare L, Bannon D, Tielsch JM, West KP Jr, Alpers MP. The influence of zinc supplementation on morbidity due to Plasmodium falciparum: a randomized trial in preschool children in Papua New Guinea. Am J Trop Med Hyg. 2000 Jun;62(6):663-9. doi: 10.4269/ajtmh.2000.62.663.

    PubMed 11304051
  • de Boer M, Thorne-Lyman AL, Shamim AA, Wu LS, Shaikh S, Ali H, West KP, Christian P. Dietary diversity as a modifier of the effect of supplementation with multiple micronutrients during pregnancy on low birth weight in a randomized controlled trial in Bangladesh. Am J Clin Nutr. 2025 Sep;122(3):762-769. doi: 10.1016/j.ajcnut.2025.07.007. Epub 2025 Jul 12.

    PubMed 40653272
  • Finkelstein JL, Cuthbert A, Weeks J, Venkatramanan S, Larvie DY, De-Regil LM, Garcia-Casal MN. Daily oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2024 Aug 15;8(8):CD004736. doi: 10.1002/14651858.CD004736.pub6.

    PubMed 39145520
  • Kim H, Bedsaul-Fryer JR, Schulze KJ, Sincerbeaux G, Baker S, Rebholz CM, Wu LS, Gogain J, Cuddeback L, Yager JD, De Luca LM, Siddiqua TJ, West KP Jr. An Early Gestation Plasma Inflammasome in Rural Bangladeshi Women. Biomolecules. 2024 Jun 21;14(7):736. doi: 10.3390/biom14070736.

    PubMed 39062451

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Iron (27 mg) - folic acid (600 ug) and Multiple micronutrient in people with Infant Mortality and Preterm Birth, run by Johns Hopkins Bloomberg School of Public Health at 2 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Oct 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States, Bangladesh. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 27 May 2015). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Infant Mortality Through 6 mo of Age (time frame: 6-months post-birth). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00860470, which also lists 24 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Oct 2022.

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