Onset of Labor and Metabolomics (GEM-2)
Premature birth is a public health problem and its incidence has recently increased in all developed countries. In Canada, it represented 6.4% of births in 1981 and 7.6% in 2000. In the last decade, the survival rate of premature infants has increased considerably, but neurological vulnerability has not changed. Premature births are the cause of approximately 28% of neonatal mortality in the world and is the major cause of perinatal mortality and morbidity in developed countries.
Approximately 75-80% of preterm births are spontaneous preterm birth. This type of premature birth included the preterm labor and premature rupture of membranes before term. The contractile activity represents one of the fundamental properties of the uterus during pregnancy and childbirth. The abnormalities associated with uterine contractions are the cause of pathological conditions with important consequences for the mother and fetus.
Metabolomics involves a new technology to investigate small molecules that characterize biochemical pathways of interest. The change in concentration levels of these molecules in various biological samples such as urine and blood in the presence of a disease or a patient can be particularly useful for identifying new biomarkers.
The hypothesis of this study is that gestational metabolomes detected in maternal fluids differ according to pathological situations and lead to the initiation of spontaneous labor. The whole research program has two complementary objectives in order to expect a decrease of prematurity: a) better understanding of all the physiological mechanisms leading to prematurity and b) better identification of patients at high risk for a better management of these women.
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Feasibility Study to Develop the Analysis of the Metabolome During the Onset of Labor During Pregnancy|
- comparison between the metabolic patterns of women before and during labor [ Time Frame: one and half year ] [ Designated as safety issue: No ]
- The study also looks at the comparison of metabolic patterns in late pregnancy and postpartum. [ Time Frame: one and half year ] [ Designated as safety issue: No ]
- The project will characterize the metabolome in different fluids collected [ Time Frame: one and half year ] [ Designated as safety issue: No ]
- The study will compare the metabolome of women with spontaneous onset of labor with that of women with premature rupture of membranes or induction of labor [ Time Frame: one and half year ] [ Designated as safety issue: No ]
Biospecimen Retention: Samples Without DNA
Vaginal secretions, whole blood and urine are collected
|Study Start Date:||April 2009|
|Estimated Study Completion Date:||June 2017|
|Estimated Primary Completion Date:||March 2017 (Final data collection date for primary outcome measure)|
Women who have a low risk pregnancy before onset of labor. Patients included in the study who will be hospitalized with spontaneous labor at term with intact membranes or preterm labor will be included in the study group. Patients with premature rupture of membranes or induction of labor will be analyzed separately.
Metabolomics involves a new technology using the methods of separation and detection complex to investigate a set of small molecules that characterize biochemical pathways of interest. The change in concentration levels of these molecules in various biological samples such as urine and blood in the presence of a disease or a patient can detect metabolic fingerprints that can be particularly useful for identifying new biomarkers. These will thereafter be quantified and validated by metabolic profiling. To our knowledge, there are few studies on metabolomics and pregnancy.
The studied population will be pregnant women between 20-30 weeks of gestation without any obstetrical complications.
Vaginal secretions, blood and urine samples will be taken:
- After inclusion in the project
- At hospital admission for delivery
- During labor
Blood and urine sample will also be taken:
- 48 hours after delivery
- 6-8 weeks after delivery
Please refer to this study by its ClinicalTrials.gov identifier: NCT01071668
|Centre Hospitalier de l'Université de Sherbrooke|
|Sherbrooke, Quebec, Canada, J1H 5N4|
|Principal Investigator:||Jean-Charles Pasquier, MD, PhD||Centre Hospitalier de l'Université de Sherbrooke|