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Vitamin D DeficiencyPhase 3NCT00412087

Vitamin D Status of Pregnant Women and Their Children in Eau Claire, South Carolina

A Phase 3 study testing cholecalciferol (vitamin D3) and cholecalciferol in people with Vitamin D Deficiency and Pregnancy, run by Medical University of South Carolina 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

Science News (October 2004) called vitamin D deficiency a "silent epidemic" in America, with no group unaffected. Using new guidelines of optimal vitamin D levels, more than 90% of African American women now suffer from vitamin D deficiency. Deficiency during pregnancy has profound effects on the developing fetus. Read more about this study

Who is it for?
Ages 16 to 45 years, women onlyHealthy volunteers can take part
Conditions the study is for
Vitamin D Deficiency, Pregnancy
What is being tested?
cholecalciferol (vitamin D3) and cholecalciferol
Could I receive a placebo?
No, everyone receives an active treatment
How many people
564 participants
Where
1 siteUnited States
Study dates
Jan 2007to Jul 2009
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 16 to 45 years
  • Women only
  • Healthy volunteers accepted
  • Child, Adult

Who may be able to join

  • Aim 1: Any mother who presents to her obstetrician or midwife at Eau Claire with confirmation of a singleton pregnancy will be eligible for enrollment in Aim 1.
  • Aim 2: If the mother also is <12 completed weeks of gestation, she will be eligible for participation of Aim 2 of the study. Mothers of diverse ethnic background (African-American, Asian, Caucasian, Asian and Hispanic) actively will be recruited. There are no age exclusion criteria.

Who cannot join

  • Aim 1: There are no exclusion criteria.
  • Aim 2: Mothers with pre-existing calcium, parathyroid conditions or who require chronic diuretic or cardiac medication therapy including calcium channel blockers will not be eligible for enrollment into the study. Mothers with active thyroid disease (e.g., Graves, Hashimoto's or thyroiditis) will not be eligible to participate in the study; however, mothers on thyroid supplement with normal serological parameters may participate in the study if they are without any other endocrine dysfunction. Mothers with diabetes will not be excluded from participation in the study as vitamin D deficiency appears linked with insulin resistance and may aggravate the maternal condition.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Eau Claire Cooperative Health Centers, Inc.

    Columbia, South Carolina, 29203

Other trials in United States

About this study

Official title: Vitamin D Status of Pregnant Women and Their Children in Eau Claire, South Carolina: A Prevalence and Supplementation Model for Community Health Care Centers in the U.S.

Science News (October 2004) called vitamin D deficiency a "silent epidemic" in America, with no group unaffected. Using new guidelines of optimal vitamin D levels, more than 90% of African American women now suffer from vitamin D deficiency. Deficiency during pregnancy has profound effects on the developing fetus. Other systems besides bones are affected by vitamin D deficiency, including an increased risk of autoimmune diseases such as rheumatoid arthritis, multiple sclerosis, type I diabetes, and certain cancers.

This study proposes to examine and manage vitamin D levels in more than one thousand women in an underserved population in South Carolina. The women will be from the patient population seeking OB/GYN and Pediatric services through Eau Claire Cooperative Health Centers, Inc. (ECCHC), a network of ten clinics in three counties in the center of the state approximately 70 miles from Charleston, SC. ECCHC is one of approximately 1000 community health centers supported through Health and Human Services' (HHS) Health Resources and Services Administration's (HRSA), Bureau of Primary Health Care.

Read more

The research objectives for this project will be managed through the Pediatric Nutritional Sciences Research Center of the Children's Research Institute at the Medical University of South Carolina, Charleston, SC, in collaboration with ECCHC. The research aims will evaluate vitamin D levels and possible contributing factors to the levels in pregnant women. Women who present to ECCHC within the first trimester of pregnancy will be randomized to one of two doses of vitamin D supplementation shown to be effective in other groups. Each pregnant mother will begin supplementation during the 12th week of pregnancy and will be followed closely throughout pregnancy for one year to determine the effectiveness of supplementation on vitamin D status, overall health of mother, and of her infant following delivery.

We expect to observe severe vitamin D deficiency in a considerable percentage of the mothers and their infants who receive care at ECCHC, especially those individuals with darker pigmentation. When the extent of vitamin D deficiency within each racial/ethnic group is better defined and their supplementation requirements identified, we will be better able to establish guidelines for supplementation and health maintenance, and set policy recommendations for the dietary recommended intake of vitamin D. Those women and their infants identified as deficient in vitamin D will be important in establishing community health care policies for vitamin D surveillance and supplementation strategies. The results will allow us to implement specific dietary and/or medical interventions aimed at correcting hypovitaminosis D in the population in this study and other similar populations being served by the more than 1000 community health centers nationally.

Read the detailed description

With avoidance of sunlight exposure due to lifestyle changes and concerns regarding skin cancer and the resultant widespread use of sunscreen, very few Americans are meeting their needs for vitamin D either through skin photosynthesis or dietary intake. A study published by the Centers for Disease Control (CDC) and our laboratory at the Medical University of South Carolina (MUSC) revealed that 42% of African American women in their childbearing years exhibited a deficiency of D vitamin (hypovitaminosis D) (1). Using new guidelines of optimal vitamin D levels, more than 90% of African American women now suffer from vitamin D deficiency (2). Science News (October 2004) called vitamin D deficiency a "silent epidemic" in America, with no group unaffected (3). Deficiency during pregnancy has profound effects on the developing fetus. Vitamin D deficiency affects other systems besides bones: it is associated with later, lifelong sequelae, with notable increased risk of autoimmune diseases such as rheumatoid arthritis (4), multiple sclerosis (5,6), type I diabetes (7,8), and certain cancers (7,9-14). Prevention and intervention studies only recently have been undertaken (3). A reexamination of dietary vitamin D requirements of various vulnerable populations in the U.S. is desperately needed (2,3). As a representative community with a diverse population, Eau Claire Cooperative Health Centers in South Carolina (ECCHC) serves a large percentage of African American as well as Caucasian and Hispanic women and children considered to be at high risk for vitamin D deficiency. ECCHC has eight clinics providing 1o care services to patients with special emphasis on Pediatric and OB/GYN services. Defining the prevalence of vitamin D deficiency in this patient population and the optimal vitamin D supplementation strategies for these women and their infants will become the prototype for recommendations applicable to other communities throughout the U.S.

In Specific Aim 1, the vitamin D status of a cross-sectional sample of 1000 pregnant women presenting at ECCHC for their prenatal care will be determined by measuring serum calcium, phosphorus, intact parathyroid hormone (iPTH), 25(OH)D, the nutritional marker of vitamin D as a function of ethnicity. Maternal health characteristics, skin pigmentation (using reflectance spectrophotometry), dietary characteristics (using an established food frequency questionnaire), and lifestyle profiles (using standardized questionnaires) will be ascertained as well. Any deficiency noted will lead to specific recommendations for vitamin D supplementation by the research team, with standardized strategies to monitor status following initiation of supplementation in Specific Aim 2. Based on extensive preliminary data, a supplementation regimen will be implemented and its efficacy in achieving optimal vitamin D status in these women tested in Aim 2: women within three racial groups (African American, Hispanic and Caucasian) will be stratified into two groups by their initial 25(OH)D level: Group 1, <32 ng/mL (less than optimal vitamin D status) and Group 2, ≥32 ng/mL (optimal vitamin D status). Based on our ongoing NIH study of pregnant women, each group will be randomized to receive one of two doses starting at 13 weeks' gestation: 2,000 or 4,000 IU vitamin D3/day after a universal one-month 2,000 IU/day dosing run-in period at 12 weeks' balanced by race/ethnicity. The randomization schema allows determination of both efficacy and safety for those deficient and those replete at entry into the study as a function of race/ethnicity and season.

Anticipated Results and Future Studies: We expect to observe vitamin D deficiency in a considerable percentage of the mothers and their newborn infants who receive care at ECCHC, especially those individuals with darker pigmentation. In Aims 1 \& 2, by determining the prevalence of vitamin D deficiency with each racial/ethnic group, we will establish guidelines for supplementation and health maintenance, and policy recommendations for the dietary recommended intake of vitamin D in the U.S. The results will allow us to implement specific dietary and/or medical interventions aimed at correcting hypovitaminosis D in the population in this study and other similar populations being served by the more than 1000 community health centers nationally.

Being tested
cholecalciferol (vitamin D3), cholecalciferol
Keywords
vitamin D, cholecalciferol, pregnant women
Medical subject headings
Vitamin D Deficiency

What participants receive

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

  • cholecalciferol (vitamin D3)Drug

    Also called vitamin D3

    randomized to one of two treatments: 2000 or 4000 IU vitamin D3/day

  • cholecalciferolDrug

    Also called Vitamin D3

    randomized to one of 2 treatment doses: 2000 vs. 4000 IU/day vitamin D3

  • cholecalciferolDrug

    Also called Vitamin D3

    cholecalciferol at 2000 or 4000 IU/day to be taken througout pregnancy. This follows the initial run-in dosing of 2000 IU/day starting at 12-weeks' gestation.

Study groups in NCT00412087
Study groupRoleWhat they receive
Cholecalciferol 2000 IUExperimentalWomen at 12-16 weeks' gestation are enrolled into the study to receive 2000 IU/day vitamin D3 for one month. After the run-in dose, the subjects are randomized to one of two treatment groups: either 2000 or 4000 IU/day to be taken throughout pregnancy until delivery.
Receives: Drug: cholecalciferol (vitamin D3); Drug: cholecalciferol
Cholecalciferol 4000 IUExperimentalWomen are randomized to one of 2 treatment groups: 2000 or 4000 IU vitamin D3/day
Receives: Drug: cholecalciferol (vitamin D3); Drug: cholecalciferol

What is being measured

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

  1. 25-hydroxyvitamin D at Visit 7

    25-hydroxyvitamin D at Visit 7, one month prior to delivery

    Measured: 7 months

Secondary outcomes (1)
  1. Parathyroid Hormone at Visit 7

    Intact parathyroid hormone at Visit 7, one month prior to delivery

    Measured: 7 months

Timeline

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

  1. First posted15 Dec 2006 (estimated)
  2. Study startJan 2007
  3. Primary completionJul 2009
  4. Study completionJul 2009

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
564 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00412087
Sponsor's protocol ID
HR-16476
Status last verified
Jun 2016
First submitted
13 Dec 2006
Last updated
29 Jul 2016
Data monitoring committee
Yes

Publications

  • Hollis BW, Wagner CL. Vitamin D deficiency during pregnancy: an ongoing epidemic. Am J Clin Nutr. 2006 Aug;84(2):273. doi: 10.1093/ajcn/84.1.273. No abstract available.

    PubMed 16895872
  • Hollis BW, Wagner CL. Nutritional vitamin D status during pregnancy: reasons for concern. CMAJ. 2006 Apr 25;174(9):1287-90. doi: 10.1503/cmaj.060149. No abstract available.

    PubMed 16636329
  • Hollis BW, Wagner CL. Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant. Am J Clin Nutr. 2004 Dec;80(6 Suppl):1752S-8S. doi: 10.1093/ajcn/80.6.1752S.

    PubMed 15585800
  • Hamilton SA, McNeil R, Hollis BW, Davis DJ, Winkler J, Cook C, Warner G, Bivens B, McShane P, Wagner CL. Profound Vitamin D Deficiency in a Diverse Group of Women during Pregnancy Living in a Sun-Rich Environment at Latitude 32 degrees N. Int J Endocrinol. 2010;2010:917428. doi: 10.1155/2010/917428. Epub 2010 Dec 9.

    PubMed 21197089

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing cholecalciferol (vitamin D3) and cholecalciferol in people with Vitamin D Deficiency and Pregnancy, run by Medical University of South Carolina 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 2 inclusion and 2 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 29 Jul 2016. 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. 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 10 Jun 2016). 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?

25-hydroxyvitamin D at Visit 7 (time frame: 7 months). 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 NCT00412087, which also lists 4 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 29 Jul 2016.

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