Iron Metabolism Parameters At First Trimester and preGnancy outcomE (IMAGE)

June 1, 2017 updated by: University Hospital, Clermont-Ferrand

Clinical and Biological Predictive Factors of Iron Deficiency Anemia in the Third Trimester of Pregnancy

Iron deficiency anemia is the leading cause of anemia during pregnancy, which can still reach 10 to 20% of pregnant women in developed countries, with potentially serious consequences for the child. Systematic iron supplementation remains controversial.

This study aims to identify in the first trimester of pregnancy clinical and biological predictive factors for the occurrence of iron deficiency anemia in the third trimester of pregnancy.

Study Overview

Status

Unknown

Intervention / Treatment

Detailed Description

Objectives: The main objective is to determine the prevalence of anemia (Hb ≤ 11 g / dl) in the third trimester of pregnancy (T3) and to identify the predictive factors in the first trimester (T1).

Type of study: Prospective monocentric cohort.

Experimental plan: Pregnant women are included during the ultrasound of T1. Written consent will be sought after delivery of the information notice. Hemoglobin, classical iron balance (ferritin, transferrin saturation coefficient) as well as other original parameters: hepcidin and the soluble transferrin receptor are assayed. Socioeconomic and clinical parameters likely to favor an iron deficiency are sought through validated questionnaires. Nutritional advice, combined with martial supplementation if necessary, is given according to a standardized management protocol resulting from the current international recommendations and validated by an internal committee. The prevalence of iron deficiency anemia is determined at T3 (after 34 SA). The predictive factors for this anemia will be sought according to the data collected in T1.

The 2012 WHO's recommendations are in favour of a systematic supplementation of pregnant women. Epidemiological studies show that the anaemia at the end of pregnancy increases the risk of severe anaemia in the postpartum hospital stay and the frequency of transfusions in the mother is multiplied by 9. The quality of life of the mother seems too altered by the anaemia with increased susceptibility to infections, cognitive and emotional disorders in the postpartum period and a decrease of capacity of work and performance. In the human new-born, the anaemia is associated with a risk of prematurity, low weight birth and especially a certain degree of later psycho-motor delay, or even perinatal mortality. Side effects of iron orally, it's cost, make debatable systematic supplementation as interventional studies have given contradictory results in terms of morbidity and mortality infant. In areas where the anaemia prevalence is very high, a systematic supplementation of pregnant by 60 mg of iron (with folic acid) is beneficial in children on clues of psycho-intellectual development at 12, 18 and 24 months while multiple supplementation in micronutrients (containing 30 mg of iron) is not effective. However, systematic supplementation in countries with high socioeconomic level did debate. An Australian study Interventional, controlled, randomized conducted at 430 women showed no efficacy on the intellectual development of children in 4 years, without changing the quality of life of the mother during pregnancy, the authors observing even an increase of abnormal behaviors of the children of the mothers in the Group supplemented iron. In another study, the rational is highly questionable, a treatment by Iron versus placebo was given to pregnant women not anaemic with a high haemoglobin (an average of 14 g/dl): the women who took iron had high blood pressure at the end of pregnancy more and their children had a lower birth for the term weight.

In a developed country such as the France, one can legitimately wonder about the potentially harmful effects of routine iron supplementation for a population of pregnant women mainly not anaemic. In Great Britain of the recently published recommendations are pronounced against a systematic supplementation of iron in pregnant women. Other European authors advocate focused on the rate of ferritin supplementation. However, we are lacking of studies allowing, from clinical criteria and biological precise, to better target pregnant women who could benefit from supplementation of iron in the first quarter.

Study Type

Observational

Enrollment (Anticipated)

865

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Auvergne
      • Clermont-Ferrand, Auvergne, France, 63003
        • CHU de Clermont-Ferrand

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

15 years to 50 years (Child, Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Female

Sampling Method

Non-Probability Sample

Study Population

The women were screened at the maternity clinic of the gynecology-obstetrics department of CHU Estaing in Clermont-Ferrand, France.

Description

Inclusion Criteria:

  • Pregnant women in the first trimester between 11SA and 13 SA + 6 days
  • A written agreement is needed

Exclusion Criteria:

  • Women who do not know enough about reading and writing French to answer questionnaires
  • Women under 15 at inclusion

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Pregnant women
Pregnant women are included during the ultrasound of T1. Written consent will be sought after delivery of the information notice.
The prevalence of iron deficiency anemia is determined at T3 (after 34 SA). The predictive factors for this anemia will be sought according to the data collected in T1.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Hemoglobin value
Time Frame: in the third trimestry of pregnancy
in the third trimestry of pregnancy

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Rate of clinical and biological factors per patient
Time Frame: at the first trimestry of pregnancy
demographics and clinical factors and biological factors (hepcidine, ferritine, RST)
at the first trimestry of pregnancy
Rate of demographics and clinical factors per patient
Time Frame: at the first trimestry of pregnancy
biological factors (hepcidine, ferritine, RST)
at the first trimestry of pregnancy
Rate of biological factors per patient
Time Frame: at the first trimestry of pregnancy
Such as : hepcidine, ferritine, RST
at the first trimestry of pregnancy

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Marc RUIVARD, MD, PhD, CHU de Clermont-Ferrand

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 12, 2015

Primary Completion (Anticipated)

June 1, 2017

Study Completion (Anticipated)

January 1, 2018

Study Registration Dates

First Submitted

May 30, 2017

First Submitted That Met QC Criteria

June 1, 2017

First Posted (Actual)

June 5, 2017

Study Record Updates

Last Update Posted (Actual)

June 5, 2017

Last Update Submitted That Met QC Criteria

June 1, 2017

Last Verified

May 1, 2017

More Information

Terms related to this study

Other Study ID Numbers

  • CHU-336
  • 2015-A00454-45 (Other Identifier: 2015-A00454-45)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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