High Dose Folic Acid Supplementation Throughout Pregnancy for Preeclampsia Prevention (FACT)
Pregnancy Complications, Preeclampsia
About this trial
This is an interventional prevention trial for Pregnancy Complications focused on measuring Pregnancy, Folic Acid supplementation, Preeclampsia
Eligibility Criteria
Inclusion Criteria:
- Capability of subject to comprehend and comply with study requirements
- ≥ 18 years of age at time of consent
- Subject is taking ≤1.1 mg of folic acid daily at the time of randomization
- Live fetus (documented positive fetal heart prior to randomization)
- Gestational age between 8+0 and 16+6 weeks of pregnancy (Gestational age (GA) of subjects will be calculated based on the first day of the last menstrual period (LMP) or ultrasound performed before 12+6. If early ultrasound and LMP dates differ by ≤ 7 days, base GA estimate on LMP date; if > 7 days, use early < 12+6 ultrasound)
- Subject plans to give birth in a participating hospital site
Pregnant subjects must fulfill at least one of the following identified risk factors for pre-eclampsia (PE):
- Pre-existing hypertension (documented evidence of diastolic blood pressure ≥ 90 mmHg on two separate occasions or at least 4 hours apart prior to randomization, or use of antihypertensive medication during this pregnancy specifically for the treatment of hypertension prior to randomization)
- Pre-pregnancy diabetes (documented evidence of Type I or type II DM)
- Twin pregnancy
- Documented evidence of history of PE in a previous pregnancy
- BMI > 35 kg/m2 within 3 months prior to this pregnancy and up to randomization of this pregnancy (documented evidence of height and weight to calculate BMI is required)
Exclusion Criteria:
- Known history or presence of any clinically significant disease or condition which would be a contraindication to folic acid supplementation of up to 5 mg daily for the duration of pregnancy
- Known major fetal anomaly or fetal demise
History of medical complications, including:
- renal disease with altered renal function,
- epilepsy,
- cancer, or
- use of folic acid antagonists such as valproic acid
- Individual who is currently enrolled or has participated in another clinical trial or who received an investigational drug within 3 months of the date of randomization (unless approved by the Trial Coordinating Centre)
Known presence of:
- Alcohol abuse (≥ 2 drinks per day) or alcohol dependence
- Illicit drug/substance use and/or dependence
- Known hypersensitivity to folic acid
- Multiple Pregnancy (triplets or more)
- Participation in this study in a previous pregnancy
Sites / Locations
- Hospital Escuela Eva Perón
- Hospital Provincial
- Hospital Roque Saenz Penia
- Maternidad Martin
- Sanatorio de la Mujer
- Cemic
- Hospital Cullen
- Hosptial Iturraspe
- Nepean
- Townsville
- Ipswich
- Adelaide
- Royal Women's Hospital
- Sunshine
- Calgary Foothills Medical Center
- Edmonton Lois Hole Hospital for Women
- Vancouver BC Women's Hospital and Health Center
- St-Paul's Hospital
- Fredericton Dr. Everett Chalmers Regional Hospital
- Moncton Hospital
- Saint John Regional Hospital
- Winnipeg St. Boniface General Hospital
- Winnipeg University of Manitoba
- St-John's Women's Health Centre
- Hamilton McMaster University
- Kingston
- London
- Ottawa Hospital
- Civic Hospital
- Sault Ste- Marie Sault Area Hospital
- Sunnybrook Health Sciences
- Quebec City (CHUL) Centre Hospitalier Universitaire
- Saint-Luc CHUM - Montreal
- McGill University Royal Victoria Hospital
- Sainte-Justine
- St-Mary's Hospital
- Regina Qu'Appelle Health Region
- University of West Indies
- Jubilee
- Spanishtown
- Hinchingbrooke
- Warrington and Halton Hospitals NHS Foundation Trust
- Darlington Memorial Hospital
- University Hospital of North Durham
- Cumberland Infirmary
- West Cumberland Hospital
- Fairfield
- Rochdale
- Lincolnshire
- Ormskirk
- Northwick Park Hospital
- West Middlesex University Hospital
- 49 Marine Avenue & CCGs
- Wansbeck General Hospital
- St George's Hospital
- Gateshead Queen Elizabeth Hospital
- South Tyneside District Hospital
- The Royal Wolverhampton NHS Trust, New Cross Hospital
- Blackburn
- Burnley
- North Manchester
- Guy's & St Thomas' Hospital
- South Tees Hospital
- Newcastle upon Tyne Hospitals
- North Tyneside General Hospital
- Norfolk & Norwich
- Nottingham City Hospital
- Nottingham Queens Medical Centre
- Oldham
- North Tees Hospital
- Sunderland Royal Hospital
- Hillingdon Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Folic Acid 4 mg
Placebo
Folic Acid 1.0 mg x 4 tablets will be taken daily by oral administration. The majority of women in the study will routinely take 1.0 mg folic acid in a prenatal vitamin supplement, as recommended by their primary obstetrical provider; the study requirements do not require that participants change their practice. Therefore the actual total daily dose may be up to 5.1 mg of folic acid
Women will be randomised in a 1:1 ratio to folic acid 4.0 mg or placebo