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Placental and Cord Blood Markers Associated With Premature Birth and Disorders of Premature Birth in Newborn Infants

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Venkatesh Sampath, Medical College of Wisconsin
ClinicalTrials.gov Identifier:
NCT01439048
First received: September 21, 2011
Last updated: August 27, 2015
Last verified: August 2015
  Purpose
The purpose of this study is to determine if changes in specific gene products in the placenta or cord/infant blood affect a baby's birth weight, increase the risk of premature birth, or increase the risk of developing diseases of prematurity. We would also like to characterize whether placental epigenetic changes or placental markers of environmental exposures are associated with premature birth.

Condition
Premature Birth

Study Type: Observational
Study Design: Observational Model: Case Control
Time Perspective: Prospective
Official Title: Study of Environmental Toxicants and Inflammatory Markers in Prematurity and Diseases of Prematurity

Further study details as provided by Medical College of Wisconsin:

Primary Outcome Measures:
  • Comparisons of placental gene expression and cord blood immune markers [ Time Frame: through hospital discharge ] [ Designated as safety issue: No ]
    Placental gene expression and cord-blood immune markers/function will be compared between 50 term infants and 150 preterm infants. Further, among preterm infants it will be determined whether certain patterns of gene expression and immune marker distribution are associated with specific diseases/condition and growth outcomes. Similarly, epigenetic changes in the immune genes and markers of environmental exposure will be compared between preterm infants and term infants. Associations between environment exposures and epigenetic changes and diseases of prematurity will also be determined.


Biospecimen Retention:   Samples With DNA
whole blood, placenta

Enrollment: 82
Study Start Date: June 2009
Study Completion Date: August 2015
Primary Completion Date: August 2015 (Final data collection date for primary outcome measure)
Groups/Cohorts
Term infants
Infants born at greater than 37 weeks gestation
Preterm Infants
Infants born at less than 37 weeks gestation

Detailed Description:

Prematurity, diseases of prematurity and growth-disorders of newborn infants contribute significantly to morbidity and mortality seen in newborn infants [1,2,3]. One out of eight newborn infants in the USA is born premature (gestational age less than 37 completed weeks). In 2004, of the 27,860 infants dying within the first year of life, greater than 16,000 were born premature [2]. Moreover, premature infants who survive the neonatal period are at increased risk of cerebral palsy, developmental delays, growth impairment and long-term respiratory disability [3-5]. Additionally, fetal growth restriction and fetal growth excess results in infants being delivered as small for gestational age infants or large for gestational age infants, respectively. Infants born with such growth-disorders are at increased risk of perinatal morbidity and mortality and as adults are at significant risk of obesity, type II diabetes and heart disease [6,7].

While the etiology of preterm birth and growth-disorders can be ascribed to maternal conditions, chromosomal defects or specific maternal environmental exposures in some newborn infants, for a majority the etiology remains unknown [8,9]. There is increasing evidence pointing to the role of genetic susceptibility factors in the causation of prematurity and growth-disorders of the newborn infant [8, 10-12]. Further, epigenetic changes in growth regulating or inflammatory genes in the placenta can program the fetus for premature birth, growth-disorders and other diseases in the postnatal period.

The overall objective of this application is four-fold.

  1. To determine whether altered placental or fetal expression of imprinted genes is associated with disorders of growth, prematurity or other postnatal diseases in newborn infants.
  2. To determine whether altered placental expression of genes that regulate the innate immune response is associated with premature birth or other postnatal diseases in newborn infants.
  3. To determine whether placental markers of environmental exposure (such as Polycyclic Aromatic Hydrocarbons or PAH) or epigenetic changes in placental inflammatory genes or growth genes are associated with prematurity or postnatal diseases in newborn infants.
  4. To determine whether cord blood immune responses and markers of immune-cell function are different between preterm and term infants and are associated with postnatal diseases in preterm infants.
  Eligibility

Ages Eligible for Study:   up to 3 Months   (Child)
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Sampling Method:   Probability Sample
Study Population
Infants who are born both premature (less than 37 weeks gestation) and full term infants (greater than 37 weeks gestation).
Criteria

Inclusion Criteria:

  • all infants born alive

Exclusion Criteria:

  • infants who are born with no signs of life
  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: NCT01439048

Locations
United States, Wisconsin
Froedtert Memorial Lutheran Hospital
Wauwatosa, Wisconsin, United States, 53226
Sponsors and Collaborators
Medical College of Wisconsin
Investigators
Principal Investigator: Venkatesh Sampath, MBBS Medical College of Wisconsin
  More Information

Publications:

Responsible Party: Venkatesh Sampath, Staff Physician, Medical College of Wisconsin
ClinicalTrials.gov Identifier: NCT01439048     History of Changes
Other Study ID Numbers: CHW 09/102, GC 900 
Study First Received: September 21, 2011
Last Updated: August 27, 2015
Health Authority: United States: Institutional Review Board

Keywords provided by Medical College of Wisconsin:
Placenta
Cord Blood
PAH
Environmental Markers
Toll-Like Receptors

Additional relevant MeSH terms:
Premature Birth
Obstetric Labor, Premature
Obstetric Labor Complications
Pregnancy Complications

ClinicalTrials.gov processed this record on September 29, 2016