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Iron-deficiencyNCT03646487

A Randomized Placebo Controlled Pilot Study of Probiotic Supplementation in At-risk Pregnant Women

A study testing Probiotic LP299v 10x10 colony forming units in capsule form in people with Iron-deficiency and Pregnancy, High Risk, run by University of Illinois at Chicago at 1 site in United States.

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 goal of this randomized supplementation feasibility trial is to learn about the feasibility and preliminary efficacy of the probiotic, lactobacillus plantarum 299v (Lp299v), in pregnant individuals at-risk for iron deficiency anemia. Read more about this study

Who is it for?
Ages 18 to 45 years, women onlyHealthy volunteers can take part
What is being tested?
Probiotic LP299v 10x10 colony forming units in capsule form
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
20 participants
Where
1 siteUnited States
Study dates
19 Nov 2018to 21 Jul 2020
Phase
Interventional
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 18 to 45 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • a 1st trimester hemoglobin (Hb) of 10.0 - 11.9 g/dl demonstrating ID or risk for prenatal ID
  • singleton
  • naturally conceived pregnancy
  • < 20 weeks gestation
  • 18 - 45 years of age
  • sufficient fluency in English to complete study forms
  • refrain from non-study dietary and pre-/probiotic supplements while enrolled in the study

Who cannot join

  • oral antibiotic use within the past 2 months
  • autoimmune disease
  • infection
  • receiving steroid treatment
  • bariatric surgery
  • inflammatory bowel disease
Show all 11Show fewer
  • hyperemesis
  • hematologic disorder (e.g., sickle cell disease)
  • current tobacco use
  • substance abuse in the last 6 months
  • other chronic disorders such as type 2 diabetes

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Illinois at Chicago

    Chicago, Illinois, 60612

Other trials in United States

About this study

Official title: "Pro-Moms" - Mitigating the Effects of Structural Violence on Maternal Iron Status: a Randomized Placebo Controlled Pilot Study of Probiotic Supplementation in At-risk Pregnant Women

The goal of this randomized supplementation feasibility trial is to learn about the feasibility and preliminary efficacy of the probiotic, lactobacillus plantarum 299v (Lp299v), in pregnant individuals at-risk for iron deficiency anemia.

The main questions it aims to answer are:

Read more
  • Is daily oral Lp299v a feasible and tolerable intervention for pregnant individuals to uptake?
  • Does daily oral Lp299v in pregnancy impact maternal and neonatal cord hematological and iron status parameters?

Participants will be randomly assigned to one of two treatment groups: daily intake or probiotic Lp299v + prenatal vitamin with iron or placebo + prenatal vitamin with iron from 15-20 weeks of gestation through delivery.

Researchers will compare the two treatment groups to see if there is a difference in the feasibility of the intervention and the preliminary efficacy on maternal and neonatal cord hematological and iron status parameters.

Read the detailed description

The most prevalent micronutrient deficiency in the United States (U.S.) is iron; a large majority of cases of iron deficiency (ID) and iron deficiency anemia (IDA) occur among pregnant women. During pregnancy, maternal iron stores are used for the growing fetus, maternal red blood cell (RBC) expansion, and placental growth and development, thus increasing the risk for ID and IDA. Across all trimesters of pregnancy in the U.S., it is estimated that 18% of individuals have ID and 5% have IDA, and within the third trimester, the prevalence of ID exceeds 27%. Prevalence of IDA is even greater among those who identify as Black or low-income. Maternal ID and IDA are associated with increased risk of preterm birth, low infant birth weight, maternal and fetal mortality, and irreversible infant neurocognitive defects. To meet this increasing requirement for iron and to optimize maternal iron nutrition, the Recommended Dietary Allowance for pregnancy is 27 mg/day of iron. However, given the continued high rates of maternal ID and IDA and only modest adherence to daily prenatal vitamins containing iron, alternative approaches to optimizing iron nutrition in pregnancy are needed.

Research has shown that one-time or short-term dosing of the probiotic Lactobacillus plantarum 299v (Lp299v) enhances iron absorption in non-pregnant populations. However, few studies have examined the effect of long-term supplementation on body iron stores. While probiotics are considered safe to consume in pregnancy, only one Lp299v supplementation trial has been conducted during the gestational period to evaluate its effects on maternal iron stores and risk of IDA. This study, among iron-sufficient pregnant Swedish women, showed a significantly lower decline in iron stores and a significantly lower prevalence of IDA in the third trimester among those randomized to Lp299v compared to standard care control.

These results offer potential positive effects for the role of Lp299v in maintaining maternal iron status among those starting pregnancy with sufficient iron stores and who receive care in a decentralized publicly funded healthcare system. However, no studies have evaluated the effect of Lp299v on maternal iron status among individuals at risk for IDA in pregnancy in the U.S., nor have studies extended findings to neonatal iron status. Moreover, it is unknown if positive feasibility and preliminary efficacy would persist in a U.S.-based health care setting with racially, ethnically, and socioeconomically diverse pregnant individuals. Therefore, the objectives of this study were as follows. First and foremost, we examined the feasibility of daily oral Lp299v maternal supplementation taken from the early second trimester through birth. Second, we explored the preliminary efficacy of Lp299v intake on maternal (at-risk for IDA defined as hemoglobin (Hb) between 10.0-12.0 g/dL) and neonatal cord hematological and iron status parameters compared to controls in an urban U.S. academic medical center with a racially, ethnically, and socioeconomically diverse patient population.

Being tested
Probiotic LP299v 10x10 colony forming units in capsule form, Placebo in capsule form
Keywords
pregnancy, iron status, structural violence
Medical subject headings
Anemia, Iron-Deficiency, Stress, Psychological

What participants receive

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

  • Probiotic LP299v 10x10 colony forming units in capsule formDietary supplement

    Daily lactobacillus plantarum (LP299v) 10x10 colony forming units in capsule form

  • Placebo in capsule formOther

    Daily placebo in capsule form

Study groups in NCT03646487
Study groupRoleWhat they receive
Probiotic LP299vExperimentalWomen will receive 1 LP299v (10x10 colony forming units) in capsule form and 1 standard prenatal supplement in tablet form daily beginning at 15 weeks gestation through delivery.
Receives: Dietary Supplement: Probiotic LP299v 10x10 colony forming units in capsule form
PlaceboPlacebo comparatorWomen will receive 1 placebo in capsule form and 1 standard prenatal supplement in table form daily beginning at 15 weeks gestation through delivery.
Receives: Other: Placebo in capsule form

What is being measured

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

  1. Mean Adherence to the Supplement Regimen

    Mean adherence to the supplement regimen using Pillsy smart bottles and standard pill counts.

    Measured: 15 weeks gestation through delivery, an average of 25 weeks

Secondary outcomes (15)
  1. Number of Treatment-emergent Adverse Events Related to GI Symptoms

    Adverse events were captured using the Maternal Adherence Form beginning with the first pill refill visit through delivery. number of participants reporting adverse GI events

    Measured: 15 weeks gestation through delivery, an average of 25 weeks

  2. Maternal Hemoglobin

    change in mean maternal serum hemoglobin (g/dl) from baseline to delivery

    Measured: Assessed at baseline (i.e., 15-20 weeks gestation) through delivery; mean change from baseline to delivery is reported.

  3. Maternal Hematocrit

    Change in mean maternal serum hematocrit (%) from baseline to delivery

    Measured: Assessed at baseline (i.e., 15-20 weeks gestation) through delivery; mean change from baseline to delivery is reported.

  4. Maternal Iron

    change in mean maternal serum iron (µg/dL) from baseline to delivery

    Measured: Assessed at baseline (i.e., 15-20 weeks gestation) through delivery; mean change from baseline to delivery is reported.

  5. Maternal Total Iron Binding Capacity

    change in mean maternal total iron binding capacity (µmol/L) from baseline to delivery

    Measured: Assessed at baseline (i.e., 15-20 weeks gestation) through delivery; mean change from baseline to delivery is reported.

  6. Maternal Serum Ferritin

    change in mean maternal serum ferritin (ng/mL) from baseline to delivery

    Measured: Assessed at baseline (i.e., 15-20 weeks gestation) through delivery; mean change from baseline to delivery is reported.

  7. Maternal Transferrin Saturation

    change in mean maternal transferrin saturation (%) from baseline to delivery

    Measured: Assessed at baseline (i.e., 15-20 weeks gestation) through delivery; mean change from baseline to delivery is reported.

  8. Maternal High-sensitivity C-reactive Protein (Hs-CRP)

    change in mean maternal high-sensitivity C-reactive protein (hs-CRP) (mg/L) from baseline to delivery

    Measured: Assessed at baseline (i.e., 15-20 weeks gestation) through delivery; mean change from baseline to delivery is reported.

  9. Maternal Iron Deficiency Anemia

    Number of participants who had iron deficiency anemia (IDA) at delivery. Hemoglobin, obtained from the Complete Blood Count, was used to define trimester-specific maternal IDA, with a downward correction of 0.8 g/dL for Black women. At the time of the study, it was recommended to use a race-adjusted cut-point for IDA. However, this race-adjusted cut-point was recently determined to be unfounded. IDA ranges included hemoglobin ≤11 g/dL for the first trimester, ≤10.5 g/dL for the second trimester, and ≤11 g/dL for the third trimester. IDA ranges with the correction for Black women were hemoglobin ≤10.2 g/dL for the first trimester, ≤9.7 g/dL for the second trimester, and ≤10.2 g/dL for the third trimester.

    Measured: Assessed at baseline (i.e., 15-20 weeks gestation) through delivery; mean change from baseline to delivery is reported.

  10. Infant Hemoglobin

    Mean infant serum hemoglobin (g/dl) from cord blood at delivery.

    Measured: delivery

  11. Infant Hematocrit

    Mean infant serum hematocrit (%) from cord blood at delivery.

    Measured: delivery

  12. Infant Iron

    Mean infant serum iron (µg/dL) from cord blood at delivery.

    Measured: delivery

  13. Infant Total Iron Binding Capacity

    Mean infant total iron binding capacity (µmol/L) from cord blood at delivery.

    Measured: delivery

  14. Infant Serum Ferritin

    Mean infant serum ferritin (ng/mL) from cord blood at delivery.

    Measured: delivery

  15. Infant Transferrin Saturation

    Mean infant transferrin saturation (%) from cord blood at delivery.

    Measured: delivery

Timeline

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

  1. First posted24 Aug 2018
  2. Study start19 Nov 2018
  3. Primary completion21 Jul 2020
  4. Study completion21 Jul 2020

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 N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03646487
Sponsor's protocol ID
2016-0662
Other IDs
5R34HL155481-03
Status last verified
Apr 2023
First submitted
20 Aug 2018
Last updated
7 Apr 2023
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • OjiNjideka Hemphill N, Pezley L, Steffen A, Elam G, Kominiarek MA, Odoms-Young A, Kessee N, Hamm A, Tussing-Humphreys L, Koenig MD. Feasibility Study of Lactobacillus Plantarum 299v Probiotic Supplementation in an Urban Academic Facility among Diverse Pregnant Individuals. Nutrients. 2023 Feb 9;15(4):875. doi: 10.3390/nu15040875.

    PubMed 36839232

Questions about this trial

What is this clinical trial studying?

A study testing Probiotic LP299v 10x10 colony forming units in capsule form in people with Iron-deficiency and Pregnancy, High Risk, run by University of Illinois at Chicago at 1 site in United States.

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 7 inclusion and 11 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 7 Apr 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 7 Apr 2023). 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?

Mean Adherence to the Supplement Regimen (time frame: 15 weeks gestation through delivery, an average of 25 weeks). 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 NCT03646487, which also lists 1 linked publication.

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 7 Apr 2023.

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