Clinical Trial: Effect of Energy Dense Biscuits in Undernourished Women on Birth Weight of Their Neonates

Study Status: Active, not recruiting
Recruit Status: Active, not recruiting
Study Type: Interventional

Official Title: Effect of Energy Dense Biscuits in Under Nourished Pregnant Women on Birth Weight of Their Newborns in a Low Income Peri-urban Setting of Karachi; a Community Based Random

Brief Summary: A nutrition trial which is based on the evidence that multivitamins & micro nutrients provided during pregnancy in malnourished women will improve neonatal birth weight. There will be two arms. Arm one will provide energy dense biscuits to pregnant women with BMI <20 & gestational age less than 14 weeks. The other arm with same criteria will be provided with wheat flour, oil, iron & folic acid. Neonatal birth weight is the primary outcome of interest but maternal weight gain, maternal hemoglobin & ferritin levels and palatability of biscuits will also be assessed.

Detailed Summary:

It has been realized that micronutrient deficiencies are a major determinant of intra-uterine growth retardation (IUGR) so multiple trials using micronutrient supplementation during pregnancy have been done & shown a positive effect on birth weight.UNICEF/WHO/United Nations University(UNU) designed a new multiple micro nutrient supplement for pregnant and lactating women—the UNICEF/WHO/UNU international multiple micro nutrient preparation (UNIMMAP)—that provides the Recommended Dietary Allowance (RDA) of 15 vitamins and minerals. The benefit of this supplementation over routinely prescribed iron and folic supplementation has been proven in multiple trials. Evidence has shown reduction in low birth newborns.

This randomized controlled trial will compare the effect of calories and multiple micro nutrients provided in energy dense biscuits manufactured by EBM to malnourished pregnant women seen by AKU's Department of Paediatrics and Child Health at their Ali Akbar Shah Goth and Ibrahim Hyderi, compared to food supplementation ration of wheat and oil, plus iron and folic acid tablet supplementation.

Arm 1: Dietary supplementation with EBM biscuits containing multiple vitamins and calcium in the recommended allowance (RDA) for pregnant women Arm 2: Supplementation with Wheat flour and oil, iron and folic acid All undernourished pregnant females identified before 14 weeks of gestation through our surveillance system will be offered enrollment.

First contact: First meeting will be on enrollment. Patients will be randomized into any one of the arm. After randomization Weight, height, MUAC and BMI will be recorded. Samples for Ferritin & hemoglobin will be drawn. In Arm 1 participant will be supplied with energy dense biscuits while in arm 2 will be provided with
Sponsor: Aga Khan University

Current Primary Outcome: Neonatal birth weight [ Time Frame: within 48 hours of birth ]

Newborns will be captured within 48 hours of their birth and their birthweight will be measured


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Maternal weight gain [ Time Frame: on enrolment,20-22 week, 33-35 week of gestation ]
    Maternal weight gain will be assessed by checking maternal weight on all three visits
  • Maternal Hemoglobin and Ferritin [ Time Frame: On enrollment and last visit (33-35 weeks of gestation) ]
    Maternal Hemoglobin and Ferritin will be checked by drawing blood on enrollment and on 33-35 weeks of gestation
  • Palatability, acceptability, and compliance of the biscuits [ Time Frame: On last visit (33-35 weeks of gestation) ]
    Palatability, acceptability, and compliance of the biscuits by filling a preformed questionnaire


Original Secondary Outcome: Same as current

Information By: Aga Khan University

Dates:
Date Received: November 5, 2014
Date Started: September 2014
Date Completion: March 2016
Last Updated: January 7, 2016
Last Verified: January 2016