Iron Deficiency Anemia of PregnancyADIPREGNCT06425796
Adiposity and Iron Requirements in Pregnancy
A study testing Adiposity and Iron Requirements in Pregnancy (ADIPREG) in people with Iron Deficiency Anemia of Pregnancy, run by University of Ulster at 3 sites in United Kingdom.
Trial summary
This study aims to explore how body fat influences the response to either 25 or 50 mg of daily iron supplements during pregnancy. We will conduct a double-blind randomized controlled intervention study involving 312 pregnant women recruited from antenatal clinics in the Northern Trust Area. Read more about this study
- Who is it for?
- Ages 18 years and older, women onlyHealthy volunteers can take part
- Conditions the study is for
- Iron Deficiency Anemia of Pregnancy
- What is being tested?
- Adiposity and Iron Requirements in Pregnancy (ADIPREG)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 312 participants
- Where
- 3 sitesUnited Kingdom
- Study dates
- 20 May 2024to 19 Mar 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 years and older
- Women only
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Age ≥ 18 years
- BMI ≥18.5 kg/m2
- Without current pregnancy complications (for example, severe bleeding, Diabetes Mellitus, hyperemesis gravidarum, ectopic and molar pregnancies)
- At least 12 Gestational Week
- Singleton pregnancy confirmed with the first ultrasound scan
- Participants who are currently taking multivitamins will be included. They will be asked to discontinue any current supplementation.
Who cannot join
- Hb <110 g/L
- SF <30 μg/L
- High risk of iron overload (Hb >150 g/L, transferrin saturation >45% or SF> 150 μg/L)
- Participants with history of haematological, renal, liver, autoimmune disorders, malabsorptive syndromes
- Participants with history of bariatric surgery
- Participants who take steroids or anti-inflammatory treatments or drugs that affect gut absorption (proton-pump inhibitors)
Show all 10Show fewer
- Planned home births
- Participants currently involved in another research study
- Multiple pregnancy
- Participants who do not speak English
Trial locations and contacts
3 sites in 1 country. Contact the study team or a site near you to ask about taking part.
United Kingdom3 sites, 3 recruiting
- Recruiting
Causeway Hospital
Coleraine, Co Londonderry, BT52 1HS
Karen Rodgers, Senior Midwife, 02870 327032, karen.rodgers@northerntrust.hscni.net
- Recruiting
Causeway Hospital
Coleraine, Co. Londonderry, BT52 1HS
Dr Jonathan White, MBChB; MRCOG, 02870347864, jonathan.white@northerntrust.hscni.net
Karen Rodgers, Senior Midwife, 02870 327032, karen.rodgers@northerntrust.hscni.net
- Recruiting
Ulster University,Human Intervention Studies Unit,
Coleraine, Co. Londonderry, BT521SA
Ruth Price, PhD, 00442870123878, rk.price@ulster.ac.uk
Geraldine Horigan, PhD, +44 2870 123043 ext. 23043, gb.horigan@ulster.ac.uk
About this study
Official title: Impact of Maternal Adiposity on Maternal Iron Status and Requirements: a Randomised Intervention Study
This study aims to explore how body fat influences the response to either 25 or 50 mg of daily iron supplements during pregnancy. We will conduct a double-blind randomized controlled intervention study involving 312 pregnant women recruited from antenatal clinics in the Northern Trust Area. Participants will be randomly assigned to receive either 25 or 50 mg of iron per day from 12 weeks of pregnancy until delivery, using the Active Iron supplement brand. Blood samples will be collected at 12, 28 and 36 weeks gestation and umbilical cord blood will be collected at delivery. Anthropometric measurements will be taken at each visit, and participants will complete questionnaires on various aspects of health and lifestyle, mental health, gastrointestinal symptoms, and compliance.
Read the detailed description
The main aim of this study is to investigate the influence of adiposity on the difference in response to 25 or 50 mg of daily iron supplementation during pregnancy. The primary aim is to determine the influence of maternal adiposity on adjusted maternal ferritin concentrations in response to 25 mg or 50 mg iron supplementation in pregnancy. The secondary outcomes of this study include: investigating the impact of maternal body fat on various maternal iron biomarkers (such as haemoglobin, soluble transferrin receptor, hepcidin, transferrin saturation, and other haematological markers) in response to either 25 mg or 50 mg iron supplementation during pregnancy, evaluating changes in adjusted ferritin concentrations and other iron markers throughout pregnancy relative to the dosage of iron supplementation received, determining the effect of maternal body fat on neonatal iron biomarkers in response to maternal iron supplementation, assessing changes in markers of inflammation in response to iron supplementation during pregnancy, and examine changes in mental health scores in response to iron supplementation during pregnancy.
This is a double-blind randomised controlled intervention study, in which 312 pregnant women with singleton pregnancy, without current complications, aged ≥ 18 years and BMI ≥ 18.5 kg/m2 will be recruited. Participants who are taking multivitamins will be included. They will be asked to discontinue any current supplementation. Pregnant women with anaemia, iron deficiency, high risk of iron overload, history of bariatric surgery, who are planning home birth, are currently involved in another research study, and those who cannot speak or understand English language will be excluded.
Blood samples and anthropometric and body composition measurements will be taken at different points in the pregnancy (12, 28, 36 gestational weeks) and an umbilical cord blood sample at the time of birth. Blood concentrations of iron and inflammation markers will be analysed. General, dietary intake and lifestyle information will be collected, through a Health and Lifestyle questionnaire and a 4-day diary. Additionally, participants will complete a questionnaire about their mental health and gastrointestinal symptoms. The compliance of the supplementation will be evaluated at each timepoint. Additionally, participants will receive a telephone call to evaluate possible adverse effects and compliance of the supplementation between the timepoints (18, 24 and 32 weeks of gestation). In the event that a participant has been prescribed iron treatment, anaemia diagnosis at any time during pregnancy or the occurrence of any adverse outcome such as miscarriage, the participant will be withdrawn from the study. Electronic forms prepared in RedCap will be used to collect data.
Amendment to above protocol:
Removal of one of the exclusion criteria of the study: having a ferritin concentration < 30 ug/L at time of enrolment. Currently, ferritin is not part of routine investigations at any time during pregnancy, unless there are risk factors for iron deficiency (Pavord et al 2019).
Excluding pregnant women with low iron levels will select a very low risk population of developing iron deficiency, and therefore, they will not reflect the real effect of the intervention in this population.
- Include an 8 week postpartum sampling timepoint. The intervention will conclude as originally planned during the delivery and will not be extended. An additional timepoint will be offered and explained to participants who are already enrolled, but they will not be obligated to participate.
Postpartum anemia affects 25-30% of women (Bodnar et al., 2005). Additionally, recent unpublished data from Northern Ireland shows that 80% of women receiving 17 mg/day of iron supplementation throughout pregnancy were iron deficient by 36 weeks, with even higher rates among pregnant women with obesity. Given these findings, we will extend our assessment of iron status after the intervention by adding this postpartum timepoint.
- Conditions
- Iron Deficiency Anemia of Pregnancy
- Being tested
- Adiposity and Iron Requirements in Pregnancy (ADIPREG)
- Keywords
- Iron status, Iron Supplements, Pregnancy, Anaemia, Maternal obesity, Maternal Overweight, Body composition, Ferritin, Inflammation, Mental Health, Neonatal anaemia
- Medical subject headings
- Anemia, Pregnancy in Obesity, Inflammation, Psychological Well-Being, Anemia, Neonatal
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Adiposity and Iron Requirements in Pregnancy (ADIPREG)Dietary supplement
Iron 25 arm will receive: two iron supplements containing 12.5 mg of elemental iron + 1 multivitamin supplement (they will receive a total of 3 supplements per day).
Iron 50 arm will receive: two 25 mg elemental iron supplements + 1 multivitamin supplement (they will receive a total of 3 supplements per day).
The multivitamin supplement will contain folic acid, vitamin B1, vitamin B2, vitamin B3, vitamin B5, vitamin B6, vitamin B12, vitamin C and vitamin D. In summary, each participant will receive 3 supplements per day and instructed to take the 3 supplements together, in the morning, with breakfast. Supplements will be given to the participants when they attend for their clinic appointment. The intervention will begin at 12 gestational weeks and continue until the baby is delivered.
| Study group | Role | What they receive |
|---|---|---|
| Iron 25 | Active comparator | Iron 25 (total 25 mg/d of iron): 2 supplements of 12.5 mg of elemental iron + 1 multivitamin supplement; Receives: Dietary Supplement: Adiposity and Iron Requirements in Pregnancy (ADIPREG) |
| IRON 50 | Active comparator | Iron 50 (total 50 mg/d of iron): 2 supplements of 25 mg of elemental iron + 1 multivitamin supplement). Receives: Dietary Supplement: Adiposity and Iron Requirements in Pregnancy (ADIPREG) |
What is being measured
The primary outcome is the main question the study is designed to answer.
* - Adjusted maternal ferritin concentrations in response to iron supplementation (ng/mL)
Assessed via electrochemiluminescence immunoassay "ECLIA".
Measured: 16, 24 and 28 weeks after baseline
Secondary outcomes (14)
Hemoglobin (g/L)
Assessed via Direct Current sheat flow method (Sysmex)
Measured: 16, 24 and 28 weeks after baseline
Red blood cell count (RBC) (10^12/L)
Assessed via Direct Current sheat flow method (Sysmex)
Measured: 16, 24 and 28 weeks after baseline.
Mean cell haemoglobin (MCH) (pg
Assessed via Direct Current sheat flow method (Sysmex)
Measured: 16, 24 and 28 weeks after baseline.
Mean cell volume (MCV) (fl)
Assessed via Direct Current sheat flow method (Sysmex)
Measured: 16, 24 and 28 weeks after baseline.
Mean cell haemoglobin concentrations (MCHC) (g/dL)
Assessed via Direct Current sheat flow method (Sysmex)
Measured: 16, 24 and 28 weeks after baseline.
Red cell distribution width (RDW) (%)
Assessed via Direct Current sheat flow method (Sysmex)
Measured: 16, 24 and 28 weeks after baseline.
Transferrin (g/L)
Assessed via immunoturbidimety assay
Measured: 16, 24 and 28 weeks after baseline.
Serum iron (umol/L)
Assessed via colorimetic assay
Measured: 16, 24 and 28 weeks after baseline.
sTfR (ug/mL)
Assessed via ELISA
Measured: 16, 24 and 28 weeks after baseline.
Hepcidin (pg/mL)
Assessed via ELISA
Measured: 16, 24 and 28 weeks after baseline.
C-reactive protein (mg/mL)
Assessed via ELISA
Measured: 16, 24 and 28 weeks after baseline.
Pro- anti- inflammatory biomarkers: IL-1 β, IL-6, IL-10, IL-22, IL-17, TNF- α, IFN- γ (fg/mL)
Assessed via sandwich immunoassay
Measured: 16, 24 and 28 weeks after baseline.
Genetic variants of interest in relation to obesity and iron metabolism in response to iron supplementation.
Assessed via methylation analyses
Measured: 16, 24 and 28 weeks after baseline.
Mental health score in response to iron supplementation
CORE 10 questionnaire will be completed by each participant at each timepoint: CORE stands for "Clinical Outcomes in Routine Evaluation." The CORE-10 is a 10-item assesses psychological distress over the past week. The resulting score can be divided into categories with increasing severity: Healthy (0-5), low (6-10), mild (11-14), moderate (15-19), moderate-to-severe (20-24), and severe (25 and above). The score of this questionnaire will be collected as a numeric variable.
Measured: 16, 24 and 28 weeks after baseline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 May 2024
- Study start20 May 2024
- Primary completion19 Jan 2027 (estimated)
- Study completion19 Mar 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Iron Deficiency Anemia of PregnancyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 312 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Ulster
- Sponsor type
- University, hospital or other
- Collaborators
- Solvotrin Therapeutics - Active Iron, National Health Service, United Kingdom
- Responsible party
- Sponsor
- Investigators
- Mary McCann, PhD, Study director, University of Ulster
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06425796
- Sponsor's protocol ID
- FCBMS-23-259
- Acronym
- ADIPREG
- Status last verified
- Jun 2026
- First submitted
- 9 May 2024
- Last updated
- 1 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 1 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Impact of Maternal Adiposity on Maternal Iron Status and Requirements: a Randomised Intervention Study
- ClinicalTrials.gov ID
- NCT06425796
- Acronym / sponsor ID
- ADIPREG / FCBMS-23-259
- Conditions
- Iron Deficiency Anemia of Pregnancy
- Keywords
- Iron status, Iron Supplements, Pregnancy, Anaemia, Maternal obesity, Maternal Overweight, Body composition, Ferritin
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 312 participants (estimated)
- Lead sponsor
- University of UlsterUniversity, hospital or other
- Collaborators
- Solvotrin Therapeutics - Active Iron, National Health Service, United Kingdom
- Study start
- 20 May 2024 (actual)
- Primary completion
- 19 Jan 2027 (estimated)
- Study completion
- 19 Mar 2027 (estimated)
- First posted
- 22 May 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to explore how body fat influences the response to either 25 or 50 mg of daily iron supplements during pregnancy. We will conduct a double-blind randomized controlled intervention study involving 312 pregnant women recruited from antenatal clinics in the Northern Trust Area. Participants will be randomly assigned to receive either 25 or 50 mg of iron per day from 12 weeks of pregnancy until delivery, using the Active Iron supplement brand. Blood samples will be collected at 12, 28 and 36 weeks gestation and umbilical cord blood will be collected at delivery. Anthropometric measurements will be taken at each visit, and participants will complete questionnaires on various aspects of health and lifestyle, mental health, gastrointestinal symptoms, and compliance.
Detailed description
The main aim of this study is to investigate the influence of adiposity on the difference in response to 25 or 50 mg of daily iron supplementation during pregnancy. The primary aim is to determine the influence of maternal adiposity on adjusted maternal ferritin concentrations in response to 25 mg or 50 mg iron supplementation in pregnancy. The secondary outcomes of this study include: investigating the impact of maternal body fat on various maternal iron biomarkers (such as haemoglobin, soluble transferrin receptor, hepcidin, transferrin saturation, and other haematological markers) in response to either 25 mg or 50 mg iron supplementation during pregnancy, evaluating changes in adjusted ferritin concentrations and other iron markers throughout pregnancy relative to the dosage of iron supplementation received, determining the effect of maternal body fat on neonatal iron biomarkers in response to maternal iron supplementation, assessing changes in markers of inflammation in response to iron supplementation during pregnancy, and examine changes in mental health scores in response to iron supplementation during pregnancy.
This is a double-blind randomised controlled intervention study, in which 312 pregnant women with singleton pregnancy, without current complications, aged ≥ 18 years and BMI ≥ 18.5 kg/m2 will be recruited. Participants who are taking multivitamins will be included. They will be asked to discontinue any current supplementation. Pregnant women with anaemia, iron deficiency, high risk of iron overload, history of bariatric surgery, who are planning home birth, are currently involved in another research study, and those who cannot speak or understand English language will be excluded.
Blood samples and anthropometric and body composition measurements will be taken at different points in the pregnancy (12, 28, 36 gestational weeks) and an umbilical cord blood sample at the time of birth. Blood concentrations of iron and inflammation markers will be analysed. General, dietary intake and lifestyle information will be collected, through a Health and Lifestyle questionnaire and a 4-day diary. Additionally, participants will complete a questionnaire about their mental health and gastrointestinal symptoms. The compliance of the supplementation will be evaluated at each timepoint. Additionally, participants will receive a telephone call to evaluate possible adverse effects and compliance of the supplementation between the timepoints (18, 24 and 32 weeks of gestation). In the event that a participant has been prescribed iron treatment, anaemia diagnosis at any time during pregnancy or the occurrence of any adverse outcome such as miscarriage, the participant will be withdrawn from the study. Electronic forms prepared in RedCap will be used to collect data.
Amendment to above protocol:
Removal of one of the exclusion criteria of the study: having a ferritin concentration < 30 ug/L at time of enrolment. Currently, ferritin is not part of routine investigations at any time during pregnancy, unless there are risk factors for iron deficiency (Pavord et al 2019).
Excluding pregnant women with low iron levels will select a very low risk population of developing iron deficiency, and therefore, they will not reflect the real effect of the intervention in this population.
- Include an 8 week postpartum sampling timepoint. The intervention will conclude as originally planned during the delivery and will not be extended. An additional timepoint will be offered and explained to participants who are already enrolled, but they will not be obligated to participate.
Postpartum anemia affects 25-30% of women (Bodnar et al., 2005). Additionally, recent unpublished data from Northern Ireland shows that 80% of women receiving 17 mg/day of iron supplementation throughout pregnancy were iron deficient by 36 weeks, with even higher rates among pregnant women with obesity. Given these findings, we will extend our assessment of iron status after the intervention by adding this postpartum timepoint.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Iron 25 | Active comparator | Dietary Supplement: Adiposity and Iron Requirements in Pregnancy (ADIPREG)Iron 25 (total 25 mg/d of iron): 2 supplements of 12.5 mg of elemental iron + 1 multivitamin supplement; |
| IRON 50 | Active comparator | Dietary Supplement: Adiposity and Iron Requirements in Pregnancy (ADIPREG)Iron 50 (total 50 mg/d of iron): 2 supplements of 25 mg of elemental iron + 1 multivitamin supplement). |
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Age ≥ 18 years
- BMI ≥18.5 kg/m2
- Without current pregnancy complications (for example, severe bleeding, Diabetes Mellitus, hyperemesis gravidarum, ectopic and molar pregnancies)
- At least 12 Gestational Week
- Singleton pregnancy confirmed with the first ultrasound scan
Key exclusion criteria (10 listed)
- Hb <110 g/L
- SF <30 μg/L
- High risk of iron overload (Hb >150 g/L, transferrin saturation >45% or SF> 150 μg/L)
- Participants with history of haematological, renal, liver, autoimmune disorders, malabsorptive syndromes
- Participants with history of bariatric surgery
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Adiposity and Iron Requirements in Pregnancy (ADIPREG)Iron 25 arm will receive: two iron supplements containing 12.5 mg of elemental iron + 1 multivitamin supplement (they will receive a total of 3 supplements per day). Iron 50 arm will receive: two 25 mg elemental iron supplements + 1 multivitamin supplement (they will receive a total of 3 supplements per day). The multivitamin supplement will contain folic acid, vitamin B1, vitamin B2, vitamin B3, vitamin B5, vitamin B6, vitamin B12, vitamin C and vitamin D. In summary, each participant will receive 3 supplements per day and instructed to take the 3 supplements together, in the morning, with breakfast. Supplements will be given to the participants when they attend for their clinic appointment. The intervention will begin at 12 gestational weeks and continue until the baby is delivered. | Dietary supplement | IRON 50, Iron 25 |
Primary outcome
* - Adjusted maternal ferritin concentrations in response to iron supplementation (ng/mL)
Time frame: 16, 24 and 28 weeks after baseline
Assessed via electrochemiluminescence immunoassay "ECLIA".
14 secondary outcomes
Hemoglobin (g/L)
Time frame: 16, 24 and 28 weeks after baseline
Red blood cell count (RBC) (10^12/L)
Time frame: 16, 24 and 28 weeks after baseline.
Mean cell haemoglobin (MCH) (pg
Time frame: 16, 24 and 28 weeks after baseline.
Mean cell volume (MCV) (fl)
Time frame: 16, 24 and 28 weeks after baseline.
Mean cell haemoglobin concentrations (MCHC) (g/dL)
Time frame: 16, 24 and 28 weeks after baseline.
Red cell distribution width (RDW) (%)
Time frame: 16, 24 and 28 weeks after baseline.
Transferrin (g/L)
Time frame: 16, 24 and 28 weeks after baseline.
Serum iron (umol/L)
Time frame: 16, 24 and 28 weeks after baseline.
sTfR (ug/mL)
Time frame: 16, 24 and 28 weeks after baseline.
Hepcidin (pg/mL)
Time frame: 16, 24 and 28 weeks after baseline.
C-reactive protein (mg/mL)
Time frame: 16, 24 and 28 weeks after baseline.
Pro- anti- inflammatory biomarkers: IL-1 β, IL-6, IL-10, IL-22, IL-17, TNF- α, IFN- γ (fg/mL)
Time frame: 16, 24 and 28 weeks after baseline.
Genetic variants of interest in relation to obesity and iron metabolism in response to iron supplementation.
Time frame: 16, 24 and 28 weeks after baseline.
Mental health score in response to iron supplementation
Time frame: 16, 24 and 28 weeks after baseline
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Jul 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Mary McCann, PhD study director
University of Ulster
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Adiposity and Iron Requirements in Pregnancy (ADIPREG) in people with Iron Deficiency Anemia of Pregnancy, run by University of Ulster at 3 sites in United Kingdom.
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 6 inclusion and 10 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: looking for participants now, as of the sponsor's last update on 1 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites in United Kingdom. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Mary T McCann, PhD (+4402870123969, mt.mccann@ulster.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
* - Adjusted maternal ferritin concentrations in response to iron supplementation (ng/mL) (time frame: 16, 24 and 28 weeks after baseline). 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 1 Jul 2026.