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Iron RequirementsPILLAR_IINCT05973552

Iron Absorption and Requirements in Pregnancy and Lactation

An observational study of Iron Requirements and Pregnancy, run by University of Oxford at 1 site in Kenya.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Iron requirements increase significantly during pregnancy. Current recommendations for iron intake in pregnant and lactating women (PLW) are mainly based on factorial estimates and extrapolated from non-PLW. Read more about this study

Who is it for?
Ages 18 to 45 years, women only
Conditions the study is for
Iron Requirements, Pregnancy, Lactation
What is being tested?
CO-rebreathing, Oral iron isotope administration (54Fe) and Intravenous iron isotope administration (58Fe)
How many people
250 participants
Where
1 siteKenya
Study dates
31 Jul 2023to 1 Sep 2026
Phase
Observational
Are there results?
None posted in the registry

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
  • No healthy volunteers
  • Adult

Study population: This study will recruit 250 pregnant women in the first trimester who previously participated in a stable iron isotope study (Clinical Trial ID: NCT05266703) and received 15 mg of the stable iron isotope 57Fe as an oral dose of ferrous sulphate at least 12 months before being enrolled in this trial.

Who may be able to join

  • Providing consent to the informed consent form
  • Participation in a previous stable isotope absorption study and having received an oral dose of 15 mg 57Fe at least 12 months prior to the date of inclusion in the study
  • Positive pregnancy test and gestational age <10 weeks based on history of last menstrual period
  • Permanent residence in the study area, and not expected to leave the study site for more than 4 weeks over the following 16 months
  • Assessment of good health by professional staff at Msambweni Hospital

Who cannot join

  • Pre-pregnancy body mass index >30 kg/m2
  • Blood transfusion or intravenous iron treatment within 4 months of study start
  • Major chronic infectious disease (e.g., tuberculosis, HIV+, hepatitis)
  • Major chronic non-infectious disease (e.g., Type 1 or 2 diabetes, cancer)

Trial locations and contacts

1 site in 1 country.

Nicole Stoffel, PhD contact

+41446328393

nicole.stoffel@rdm.ox.ac.uk

Kenya1 site, 1 recruiting
  • Msambweni Referral Hospital

    Msambweni

    Edith Mwasi, MD

    Recruiting

Other trials in Kenya

About this study

Official title: Assessment of Iron Absorption and Requirements During Pregnancy and Lactation in Kenyan Women

Iron requirements increase significantly during pregnancy. Current recommendations for iron intake in pregnant and lactating women (PLW) are mainly based on factorial estimates and extrapolated from non-PLW. High-quality quantitative data on iron requirements in PLW are lacking, particularly in Sub- Saharan Africa where anaemia and infections are common.

The primary objective of this study is to use the stable iron isotope technique to determine iron requirements and assess iron absorption and losses in PLW living in Kenya.

In this prospective observational study, we will enrol pregnant women in the first trimester (n = 250) from a previous study cohort (n=1000) who participated in an iron absorption study at least 12 months ago and received the stable iron (Fe) isotope 57Fe. This 57Fe has now distributed and equilibrated throughout the women's body iron. Once enrolled in the present study, following Kenyan guidelines, women will receive standard prenatal care, including routine daily iron and folate supplementation. We will collect venous blood samples in each trimester and at delivery, and during the first 6 months of lactation in the mothers and infants (heel prick samples). To directly assess dietary iron absorption, in a randomly selected subset of women (n=35), oral and intravenous stable iron isotope tracers (54Fe, 58Fe) will be administered in the 2nd and 3rd trimesters.

Being tested
CO-rebreathing, Oral iron isotope administration (54Fe), Intravenous iron isotope administration (58Fe)
Medical subject headings
Breast Feeding

What participants receive

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

  • CO-rebreathingOther

    In the CO-rebreathing method, a dedicated apparatus is used for inhaling and rebreathing a very small bolus of CO through a spirometer for ~2 min, which is absorbed through the lungs and binds to Hb, and then the increase of HbCO content of blood is measured 8 min after the CO inhalation. The increase of COHb in blood samples can then be used to precisely calculate Hb mass and blood volume

  • Oral iron isotope administration (54Fe)Other

    Participants randomly assigned to the sub-group, will receive 54Fe with a test meal in the second and third trimester for assessment of dietary iron absorption

  • Intravenous iron isotope administration (58Fe)Other

    Participants randomly assigned to the sub-group, will receive intravenous 58Fe in the second and third trimester for assessment of erythrocyte iron incorporation

Study groups in NCT05973552
Study groupRoleWhat they receive
All participantsWomen (n=250), are followed throughout their pregnancy. Mother-infant pairs are followed throughout the first 6-months postpartum. Women receive daily oral iron supplementation during pregnancy in accordance with local standards of care. Using the stable iron isotopes dilution methodology, concentration of the stable iron isotope tracer (57Fe) in circulation will be measured throughout pregnancy and up to 6 months postpartum in both, mother and infant.
Receives: Other: CO-rebreathing
Randomly selected sub-groupTo directly assess dietary iron absorption, in a randomly selected subset of women (n=35), oral and intravenous stable iron isotope tracers (54Fe, 58Fe) will be administered. Oral iron absorption and erythrocyte iron incorporation will be measured 14 days after tracer administration.
Receives: Other: CO-rebreathing; Other: Oral iron isotope administration (54Fe); Other: Intravenous iron isotope administration (58Fe)

What is being measured

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

  1. Iron absorbed, lossed and gained in the first trimester

    isotope dilution

    Measured: Change in 57Fe tracer abundance between gestational age 6, 10 and 15 weeks

  2. Iron absorbed, lossed and gained in the second trimester

    isotope dilution

    Measured: Change in 57Fe tracer abundance between gestational age 15, 20 and 25 weeks

  3. Iron absorbed, lossed and gained in the third trimester

    isotope dilution

    Measured: Change in 57Fe tracer abundance between gestational age 25, 30 and 35 weeks

  4. Iron absorbed, lossed and gained throughout pregnancy

    isotope dilution

    Measured: Change in 57Fe tracer abundance between gestational age 6, 10, 15, 20, 25, 30 and 35 weeks

  5. Iron absorbed, lossed and gained in lactating women

    isotope dilution

    Measured: Change in 57Fe tracer abundance between 6, 14 and 24 weeks postpartum

  6. Iron absorbed, lossed and gained in infancy

    isotope dilution

    Measured: Change in 57Fe tracer abundance between age 6, 14 and 24 weeks

Secondary outcomes (102)
  1. Fractional iron absorption (%) in the second trimester

    shift in iron isotopic ratios

    Measured: gestational age 20 weeks

  2. Fractional iron absorption (%) in the third trimester

    shift in iron isotopic ratios

    Measured: gestational age 30 weeks

  3. Erythrocyte iron incorporation (%) in the second trimester

    shift in iron isotopic ratios

    Measured: gestational age 20 weeks

  4. Erythrocyte iron incorporation (%) in the third trimester

    shift in iron isotopic ratios

    Measured: gestational age 30 weeks

  5. Hemoglobin concentration (g/dl)

    Hb

    Measured: gestational age 6 weeks

  6. Hemoglobin concentration (g/dl)

    Hb

    Measured: gestational age 10 weeks

  7. Hemoglobin concentration (g/dl)

    Hb

    Measured: gestational age 15 weeks

  8. Hemoglobin concentration (g/dl)

    Hb

    Measured: gestational age 20 weeks

  9. Hemoglobin concentration (g/dl)

    Hb

    Measured: gestational age 25 weeks

  10. Hemoglobin concentration (g/dl)

    Hb

    Measured: gestational age 30 weeks

  11. Hemoglobin concentration (g/dl)

    Hb

    Measured: gestational age 36 weeks

  12. Hemoglobin concentration (g/dl)

    mother

    Measured: 6 weeks postpartum

  13. Hemoglobin concentration (g/dl)

    infant

    Measured: age 6 weeks

  14. Hemoglobin concentration (g/dl)

    mother

    Measured: 14 weeks postpartum

  15. Hemoglobin concentration (g/dl)

    infant

    Measured: age 14 weeks

  16. Hemoglobin concentration (g/dl)

    mother

    Measured: 24 weeks postpartum

  17. Hemoglobin concentration (g/dl)

    infant

    Measured: age 24 weeks

  18. Mean corpuscular volume (fl)

    MCV

    Measured: gestational age 6 weeks

  19. Mean corpuscular volume (fl)

    MCV

    Measured: gestational age 10 weeks

  20. Mean corpuscular volume (fl)

    MCV

    Measured: gestational age 20 weeks

  21. Mean corpuscular volume (fl)

    MCV

    Measured: gestational age 30 weeks

  22. Mean corpuscular volume (fl)

    mother

    Measured: 6 weeks postpartum

  23. Mean corpuscular volume (fl)

    infant

    Measured: age 6 weeks

  24. Mean corpuscular volume (fl)

    mother

    Measured: 14 weeks postpartum

  25. Mean corpuscular volume (fl)

    infant

    Measured: age 14 weeks

  26. Mean corpuscular volume (fl)

    mother

    Measured: 24 weeks postpartum

  27. Mean corpuscular volume (fl)

    infant

    Measured: age 24 weeks

  28. Erythropoietin concentration (mU/ml)

    EPO

    Measured: gestational age 10 weeks

  29. Erythropoietin concentration (mU/ml)

    EPO

    Measured: gestational age 20 weeks

  30. Erythropoietin concentration (mU/ml)

    EPO

    Measured: gestational age 30 weeks

  31. Erythropoietin concentration (mU/ml)

    EPO

    Measured: 6 weeks postpartum

  32. Erythropoietin concentration (mU/ml)

    EPO

    Measured: 14 weeks postpartum

  33. Erythropoietin concentration (mU/ml)

    EPO

    Measured: 24 weeks postpartum

  34. Erythroferrone concentration (ng/ml)

    ERFE

    Measured: gestational age 10 weeks

  35. Erythroferrone concentration (ng/ml)

    ERFE

    Measured: gestational age 20 weeks

  36. Erythroferrone concentration (ng/ml)

    ERFE

    Measured: gestational age 30 weeks

  37. Erythroferrone concentration (ng/ml)

    ERFE

    Measured: 6 weeks postpartum

  38. Erythroferrone concentration (ng/ml)

    ERFE

    Measured: 14 weeks postpartum

  39. Erythroferrone concentration (ng/ml)

    ERFE

    Measured: 24 weeks postpartum

  40. Hepcidin concentration (ng/ml)

    Hep

    Measured: gestational age 10 weeks

  41. Hepcidin concentration (ng/ml)

    Hep

    Measured: gestational age 20 weeks

  42. Hepcidin concentration (ng/ml)

    Hep

    Measured: gestational age 30 weeks

  43. Hepcidin concentration (ng/ml)

    Hep

    Measured: 6 weeks postpartum

  44. Hepcidin concentration (ng/ml)

    Hep

    Measured: 14 weeks postpartum

  45. Hepcidin concentration (ng/ml)

    Hep

    Measured: 24 weeks postpartum

  46. Serum ferritin concentration (ug/l)

    SF

    Measured: gestational age 10 weeks

  47. Serum ferritin concentration (ug/l)

    SF

    Measured: gestational age 20 weeks

  48. Serum ferritin concentration (ug/l)

    SF

    Measured: gestational age 30 weeks

  49. Serum ferritin concentration (ug/l)

    mother

    Measured: 6 weeks postpartum

  50. Serum ferritin concentration (ug/l)

    infant

    Measured: age 6 weeks

  51. Serum ferritin concentration (ug/l)

    mother

    Measured: 14 weeks postpartum

  52. Serum ferritin concentration (ug/l)

    infant

    Measured: age 14 weeks

  53. Serum ferritin concentration (ug/l)

    mother

    Measured: 24 weeks postpartum

  54. Serum ferritin concentration (ug/l)

    infant

    Measured: age 24 weeks

  55. Soluble transferrin receptor concentration (ul/l)

    sTfR

    Measured: gestational age 10 weeks

  56. Soluble transferrin receptor concentration (ul/l)

    sTfR

    Measured: gestational age 20 weeks

  57. Soluble transferrin receptor concentration (ul/l)

    sTfR

    Measured: gestational age 30 weeks

  58. Soluble transferrin receptor concentration (ul/l)

    mother

    Measured: 6 weeks postpartum

  59. Soluble transferrin receptor concentration (ul/l)

    infant

    Measured: age 6 weeks

  60. Soluble transferrin receptor concentration (ul/l)

    mother

    Measured: 14 weeks postpartum

  61. Soluble transferrin receptor concentration (ul/l)

    infant

    Measured: age 14 weeks

  62. Soluble transferrin receptor concentration (ul/l)

    mother

    Measured: 24 weeks postpartum

  63. Soluble transferrin receptor concentration (ul/l)

    infant

    Measured: age 24 weeks

  64. C-reactive protein concentration (mg/l)

    CRP

    Measured: gestational age 10 weeks

  65. C-reactive protein concentration (mg/l)

    CRP

    Measured: gestational age 20 weeks

  66. C-reactive protein concentration (mg/l)

    CRP

    Measured: gestational age 30 weeks

  67. C-reactive protein concentration (mg/l)

    mother

    Measured: 6 weeks postpartum

  68. C-reactive protein concentration (mg/l)

    infant

    Measured: age 6 weeks

  69. C-reactive protein concentration (mg/l)

    mother

    Measured: 14 weeks postpartum

  70. C-reactive protein concentration (mg/l)

    infant

    Measured: age 14 weeks

  71. C-reactive protein concentration (mg/l)

    mother

    Measured: 24 weeks postpartum

  72. C-reactive protein concentration (mg/l)

    infant

    Measured: age 24 weeks

  73. alpha-glycoprotein concentration (mg/dl)

    AGP

    Measured: gestational age 10 weeks

  74. alpha-glycoprotein concentration (mg/dl)

    AGP

    Measured: gestational age 20 weeks

  75. alpha-glycoprotein concentration (mg/dl)

    AGP

    Measured: gestational age 30 weeks

  76. alpha-glycoprotein concentration (mg/dl)

    mother

    Measured: 6 weeks postpartum

  77. alpha-glycoprotein concentration (mg/dl)

    infant

    Measured: age 6 weeks

  78. alpha-glycoprotein concentration (mg/dl)

    mother

    Measured: 14 weeks postpartum

  79. alpha-glycoprotein concentration (mg/dl)

    infant

    Measured: age 14 weeks

  80. alpha-glycoprotein concentration (mg/dl)

    mother

    Measured: 24 weeks postpartum

  81. alpha-glycoprotein concentration (mg/dl)

    infant

    Measured: age 24 weeks

  82. Blood volume (l)

    Measured: gestational age 10 weeks

  83. Blood volume (l)

    BV

    Measured: gestational age 20 weeks

  84. Blood volume (l)

    BV

    Measured: gestational age 30 weeks

  85. Blood volume (l)

    BV

    Measured: 6 weeks postpartum

  86. Blood volume (l)

    BV

    Measured: 14 weeks postpartum

  87. Blood volume (l)

    BV

    Measured: 24 weeks postpartum

  88. Intestinal fatty acid binding protein

    I-FABP

    Measured: gestational age 10 weeks

  89. Intestinal fatty acid binding protein

    I-FABP

    Measured: gestational age 20 weeks

  90. Intestinal fatty acid binding protein

    I-FABP

    Measured: gestational age 30 weeks

  91. Retinol binding protein

    RBP

    Measured: gestational age 10 weeks

  92. Retinol binding protein

    RBP

    Measured: gestational age 20 weeks

  93. Retinol binding protein

    RBP

    Measured: gestational age 30 weeks

  94. soluble CD14

    sCD14

    Measured: gestational age 10 weeks

  95. soluble CD14

    sCD14

    Measured: gestational age 20 weeks

  96. soluble CD14

    sCD14

    Measured: gestational age 30 weeks

  97. Insulin-like growth factor 1

    IGF-1

    Measured: gestational age 10 weeks

  98. Insulin-like growth factor 1

    IGF-1

    Measured: gestational age 20 weeks

  99. Insulin-like growth factor 1

    IGF-1

    Measured: gestational age 30 weeks

  100. Fibroblast growth factor 21

    FGF21

    Measured: gestational age 10 weeks

  101. Fibroblast growth factor 21

    FGF21

    Measured: gestational age 20 weeks

  102. Fibroblast growth factor 21

    FGF21

    Measured: gestational age 30 weeks

Timeline

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

  1. First posted3 Aug 2023
  2. Study start31 Jul 2023 (estimated)
  3. Primary completion30 Jun 2026 (estimated)
  4. Study completion1 Sep 2026 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
250 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05973552
Sponsor's protocol ID
PILLAR_II
Acronym
PILLAR_II
Status last verified
Jun 2023
First submitted
18 Jul 2023
Last updated
3 Aug 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Iron Requirements and Pregnancy, run by University of Oxford at 1 site in Kenya.

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 5 inclusion and 4 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: status not confirmed, as of the sponsor's last update on 3 Aug 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 Kenya. 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.

Are results available for this study?

Results are not available in the source record.

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

Contact Nicole Stoffel, PhD (+41446328393, nicole.stoffel@rdm.ox.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Iron absorbed, lossed and gained in the first trimester (time frame: Change in 57Fe tracer abundance between gestational age 6, 10 and 15 weeks). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 3 Aug 2023.

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