Congenital Malformations Clinical Trial
Official title:
Randomized Clinical Trial to Evaluate the Efficacy of High Dose of Folic Acid to Prevent the Occurrence of Congenital Malformations
In 1991 the Medical Research Council Vitamin Study Group and in 1992 the Hungarian
randomised clinical trial have shown conclusively that the risk of neural tube defects can
be reduced substantially by taking folic acid during the peri-conceptional period. At
present there is enough evidence to support the hypothesis that folic acid supplementation
can reduce the risk of all congenital malformations or of a specific and selected group of
them, namely: neural tube defects, oral clefts, cardiac defects, urinary tract anomalies
except hypospadias, limb reduction defects, omphalocele, anal atresia and trisomy 21.
The hypothesis that a higher intake of folic acid is related to an higher risk reduction of
neural tube defects and of other congenital malformations is the main rationale for the
present study.
The present study is a randomized, double-blind, controlled trial evaluating whether
supplementation with folic acid at high dose (4 mg/day) reduces the overall risk of major
congenital malformations in the population more than the standard recommended dose (0.4
mg/day). At the enrolment visit all the eligible women will be interviewed to assess
sociodemographic, life style and health status. After randomization, women will be
interviewed every 4 months to evaluate pregnancy status. Women who have a pregnancy
diagnosis during the study period will be interviewed by telephone at the expected 16, 24
and 40 weeks of gestation to evaluate the pregnancy outcome. The health status of live
births will be evaluated at the child's age of 1 month, 3 months and 1 year.
The primary aim of this project is conducting a study to assess the effect of folic acid
periconceptional supplementation of 4 mg/day compared to the 0.4 mg/day standard dose on
reducing the occurrence of all congenital malformations. Secondary aims of this study
include comparing severity of CMs in offspring of trial mothers, rates of "selected
congenital malformations", rates of twinning, miscarriages, recurrent abortions,
small-for-gestational age, preeclampsia and abruptio placentae. The sample size is not easy
to be computed because lacking robust estimate of the size effect of the treatment. Three
hypotheses of a size effect of 45%, 26% and 13% were considered. A sample size of outcomes
(and women) respectively of 2,006 (5,015), 8,510 (21,275) and 30,126 (75,315) is needed.
Since the sample size needed to evaluate different scenarios is large, the present study is
also the pilot study to promote an international prospective meta-analysis.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Prevention
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT00775788 -
Autologous Fat Grafting to the Breast
|
N/A | |
Completed |
NCT02985385 -
Lethal Congenital Malformations: Palliative Therapy From An Islamic Point of View
|
N/A | |
Completed |
NCT02483702 -
Irradiated Blood Versus Non Irradiated Blood Transfusions in Craniosynostosis Repair
|
N/A | |
Completed |
NCT03831035 -
Fast Exome for Diagnosis of Congenital Conditions in Infants Under 12 Months of Age Hospitalized in Intensive Care Unit
|