Study Title: | [1] | ||||||||
SUPPLEMENTATION OF VITAMIN B12 IN PREGNANCY AND POSTPARTUM ON GROWTH AND NEURODEVELOPMENT IN EARLY CHILDHOOD: A RANDOMIZED, PLACEBO CONTROLLED TRIAL AMONG PREGNANT WOMEN IN BHAKTAPUR, NEPAL | |||||||||
Following forms are included in separate sheets in this document. All the variables (questions) from the following forms are listed. | |||||||||
S.No | Form | Full Name | Form frequency | WHO | Where | ||||
1 | SCR | Screening Form | Before enrollment; screens eligibility | PRIXA | |||||
2 | PME | Pregnant Mother's Information Form | Before enrollment; screens eligibility | PRIXA | |||||
3 | USG | Ultrasound Form | 1.
Before enrollment; screens eligibility 2. At 18-22 wks; Anomaly scan 3. At around 9 months; third trimester scan |
PRIXA | |||||
4 | BCM | Blood Collection of Mother | 1.
Before enrollment; screens eligibility. 2. At 8 months of pregnancy 3. At 6 months after delivery |
PRIXA | |||||
5 | LAB | Laboratory Form | Before enrollment; screens eligibility | PRIXA | |||||
6 | DHI | Demographic Household Information Form | After enrollment; within week | PRIXA | |||||
7 | MIF | Mother's Information Form | After enrollment; within week | PRIXA | |||||
8 | PPH | Previous Pregnancy History form | After enrollment; within week | PRIXA | |||||
9 | FIF | Father's Information Form | After enrollment; within week | PRIXA | |||||
10 | MVF | Monthly Visit Form | Every month after enrolment until delivery | PRIXA | |||||
11 | WVF | Weekly Visit Form | Every week after enrolment until child's age is 6 months | ACCDE | TABLE_WEEKLY_VISIT | ||||
12 | CKCDI | Caregiver's Knowledge of Child Development Inventory | At
7 months of pregnancy At 1 year of child of child |
FW | IFORM | cismac_ckcdi | |||
13 | SRQ | Self Reporting Questionnaire form | At 8 months pf pregnancy, at 45 days after delivery, 6, 12 and 36 months and 7 years of baby age | FW | IFORM | cismac_srq | |||
14 | DRM | Dietary Recall of Mother | At 8 months of pregnancy | ||||||
15 | DRF | Delivery Record Form | At the ealiest after delivery | IFORM / prixa | cismac_delivery_report_form_ | ||||
16 | AMC | Anthropometric Measurement Form | Every month after delivery until child's age is 6 months | PRIXA | |||||
17 | TIMP | Test of Infant Motor Performance | At 75 days after delivery | Psyk | IFORM | cismac_timp | |||
18 | BSD | Bayley Scales of infant and toddler development, 3rd edition | At 6, 12, 24 and 36 months after delivery | Psyk | IFORM | bsd | cismac_bsd_6 | ||
19 | HOME_EC | HOME inventory Early Childhood | At 6 mnths after delivery and at 7 years | FW | IFORM | cismac_home_inventory | |||
20 | Acti | Actiwatch form | FW | ACCDE | ER1_actiwathc | ||||
21 | BCC | Blood Collection of Child | At 6 and 12 months after delivery and 7 years | PRIXA | |||||
22 | BISQ | Brief infant sleep questionnaire | At 36 months after delivery | FW | ACCDE | ||||
23 | CSHQ | Child Sleep Habits Questionaire | At 48 months, 5 and 7 years | ||||||
24 | ADBB | Alarm distress baby scale | At 6 months after delivery | Psyk | Excel | ||||
25 | ESF | End Supplementation Form | At 6 months after delivery | PRIXA | |||||
26 | ASQ | Age and Stages Questionnaire | At 9 months after delivery and at 5 years | FW | IFORM | cismac_asq3 | |||
27 | EVF | End Visit Form | At 12 months after delivery | PRIXA | |||||
28 | AEF | Adverse Effect Form | At all adverse events | IFORM | cismac_adverse_events_form | ||||
29 | NCF | Non-Continuation Form | For non-continuation of intake of biscuits by participants | IFORM | cismac_non_continuation_form_ncf_ | ||||
30 | Hos | Hospitalization of mother | At all events of hospitalization of mother | IFORM | cismac__hospitalization_form_of_other_hos | ||||
31 | AFC | Admission form of Children | At all events of hospitalization of child | IFORM | cismac_adission_form_of children__afc_ | ||||
32 | CMF | Child Morbidity Form | When a child presents with an illness at the hospital | IFORM | cismac_child_morbidity_form_ | ||||
33 | YVF | Yearly Visit Form | Every 6 months up to 9 | ||||||
34 | BIS | Bergen Insomnia Scale | At 36 months and 7 years | FW | IFORM | ||||
35 | WPPSI | Wechsler Preschool and Primary Scale of Intelligence – Fourth Edition | at 4 and 5 years of age | Psyk | |||||
36 | NEPSY | Neuropsychological Assessment | at 4 and 5 years of age | Psyk | IFORM | ||||
37 | SDQ | Strength and Difficulties Questionnaire | At 48 months, 5 and 7 years | FW | IFORM | ||||
38 | BRIEF | BRIEF | At 48 months | Supervisor | IFORM | ||||
39 | DEEP | DEEP tool | At 6 years | FW | |||||
40 | HOME_CH | HOME inventory Chilhood | At 7 years | ||||||
41 | SASQ | Short autism spectrum quotient | At 7 years | ||||||
42 | Raven | Raven | At 7 years | ||||||
43 | RTC | At 7 years | |||||||
44 | ACE | Adverse childhood experience | |||||||
45 | FDI | Follw-up demographic information | 1 time point at 60 months | ||||||
46 | FYF | Five years visit form | 1 time point at 60 months | ||||||