Prevention of Myopia of Prematurity by Calcium Supplementation

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
University of Alabama at Birmingham
ClinicalTrials.gov Identifier:
NCT00892476
First received: April 30, 2009
Last updated: December 4, 2012
Last verified: July 2010
  Purpose

The purpose of this study is to determine if supplementation of calcium by the enteral route (gut feeding) to extremely low birth weight infants will lead to less myopia (nearsightedness) at 6-12 months postnatal age.

Secondly, the study will determine if calcium supplementation is well tolerated, if it reduces the molding of these premature infants' heads, and if it decreases myopia at the 18-22 month postnatal age visit.


Condition Intervention Phase
Myopia
Dietary Supplement: Calcium Supplementation
Other: Standard of Care
Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: Prevention of Myopia of Prematurity by Calcium Supplementation in a Randomized Controlled Pilot Trial

Resource links provided by NLM:


Further study details as provided by University of Alabama at Birmingham:

Primary Outcome Measures:
  • Supplementation of Ca by the enteral route to ELBW infants will lead to an increased cycloplegic refraction at 6-12 months postnatal age. [ Time Frame: 6-12 months postnatal age ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Supplementation of Ca will lead to increased cycloplegic refraction at 18-22 months corrected age. [ Time Frame: 18-22 months corrected age ] [ Designated as safety issue: No ]
  • Supplementation of Ca will lead to an increased cycloplegic refraction at 6-12 months postnatal age and at 18-22 months corrected age in infants who had no abdominal surgery or prolonged feeding intolerance [ Time Frame: 6 months postnatal age to 18-22 months corrected age ] [ Designated as safety issue: No ]
  • Supplementation of Ca will reduce the dolichocephalic deformation of the infants' heads as measured by the FOD/BPD index. [ Time Frame: 18-22 months corrected age ] [ Designated as safety issue: No ]
  • Supplementation of Ca will reduce the incidence of fractures. [ Time Frame: birth to discharge ] [ Designated as safety issue: No ]
  • Supplementation of Ca will not increase the incidence of NEC stage 2A or greater. [ Time Frame: birth to discharge ] [ Designated as safety issue: No ]
  • Supplementation of Ca will not increase the incidence of feeding intolerance. [ Time Frame: birth to discharge ] [ Designated as safety issue: No ]
  • Supplementation of Ca is not associated with a change in the incidence of ROP. [ Time Frame: birth to full vascularization of the retina ] [ Designated as safety issue: No ]
  • Supplementation of Ca will increase bone mineral density at 36 weeks postmenstrual age (only relevant if measurement is available). [ Time Frame: 36 weeks postmenstrual age ] [ Designated as safety issue: No ]

Enrollment: 99
Study Start Date: February 2002
Study Completion Date: December 2008
Primary Completion Date: June 2004 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
Infants receive supplemental calcium in their 24 cal/oz formula or fortified breast milk.
Dietary Supplement: Calcium Supplementation

Ca-gluconate powder (molar weight 430.4 g) will be measured with household measuring spoons and added to the feeding mixtures as follows:

Amount of feeding Actual Weight < 1000 g Actual Weight < 1000 g

25 ml ¼ tsp 1/8 tsp

50 ml ½ tsp ¼ tsp

100 ml 1 tsp ½ tsp

200 ml 2 tsp 1 tsp

Other Name: USP grade Calcium gluconate powder from Sigma Chemical Company (Cat # C-8231, St. Louis, MO)
Active Comparator: 2
Infants will receive fortified breast milk or 24 cal/oz formula
Other: Standard of Care
Infants are feed breast milk with fortifier or 24 cal/oz formula per standard of care

Detailed Description:

All infants admitted meeting the 401-1000gm birthweight and less than 14 day of age entry criteria will be screened for entry into the study. Infants may be excluded for the following: Major congenital malformations, including complex congenital heart disease (except open ductus arteriosus, atrial and ventricular septal defects), pulmonary malformations, bowel or anal stenosis or atresia, renal dysplasias, chromosomal anomalies, hydrops fetalis, bowel perforation or necrotizing enterocolitis stage 2A or greater before randomization.

Written informed consent of one parent or legal guardian must be obtained. The infants are randomized to receive unsupplemented feedings of breast milk or formula, or feedings supplemented with Ca-gluconate as outlined below.

Randomization will be stratified into the following groups: 401-750 g and 751-1000 g and performed according to a balanced block scheme with variable block size (2-6) using sealed opaque envelopes.

Total parenteral nutrition is given by nursery unit standards. Infant positioning is done by nursery unit standards.

Feeding mixtures:

Supplementation is started when enteral feeding amounts to 100 ml/kg. At that time, fortification is also introduced in infants receiving breast milk. Fortified human milk or 24 cal/oz formula, e.g. Similac Special Care 24 (SSC24), is used in all participating infants. Human milk is fortified with 1 pk Enfamil human milk fortifier per 25 ml (BMHMF).

Control group: Fortified human milk or 24 cal/oz formula. Supplemented group: Ca-gluconate powder (molar weight 430.4 g) will be measured with household measuring spoons (e.g. Rubbermaid (R)) and added to the feeding mixtures.

One eye exam will be performed at 6-12 months during routine follow-up visit. A second eye exam will be performed at 18-2 months during a follow-up visit which is part of the NICHD newborn follow-up clinic. Head measurements, specifically, front-to-back and side-to-side will be measured at randomization, 36 weeks postmenstrual age or discharge, whichever occurs first, and during the follow up visits. Urinalysis will be collected weekly.

  Eligibility

Ages Eligible for Study:   up to 14 Days
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Infants with a birthweight of 401 - 1000 g and postnatal age less than 14 days

Exclusion Criteria:

  • Major congenital malformations including

    • complex congenital heart disease (except open ductus arteriosus, atrial and ventricular septal defects)
    • pulmonary malformations
    • bowel or anal stenosis or atresia
    • renal dysplasias
    • chromosomal anomalies
    • hydrops fetalis
    • bowel perforation or necrotizing enterocolitis stage 2A or greater before randomization.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00892476

Sponsors and Collaborators
University of Alabama at Birmingham
Investigators
Principal Investigator: Waldemar Carlo, MD University of Alabama at Birmingham
  More Information

No publications provided by University of Alabama at Birmingham

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: University of Alabama at Birmingham
ClinicalTrials.gov Identifier: NCT00892476     History of Changes
Other Study ID Numbers: F010613009
Study First Received: April 30, 2009
Last Updated: December 4, 2012
Health Authority: United States: Institutional Review Board

Keywords provided by University of Alabama at Birmingham:
myopia
calcium supplementation
prematurity

Additional relevant MeSH terms:
Myopia
Eye Diseases
Refractive Errors
Calcium, Dietary
Bone Density Conservation Agents
Pharmacologic Actions
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on October 20, 2014