Screening To Obviate Preterm Birth (STOP)

Study Description

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Brief Summary:

Our objective is to investigate the predictive value of a panel of biomarkers associated with two biologically plausible pathways of preterm birth: membrane breakdown and cervical remodeling. The investigators will obtain cervical length, cervicovaginal fetal fibronectin, and a panel of novel cervicovaginal biomarkers associated with cervical remodeling in a prospective cohort of symptomatic women with a singleton pregnancy at high risk for preterm birth in an effort to better risk stratify this cohort.

Condition or disease
Preterm Labor; Preterm Contractions; Abdominal Cramping; Back Pain; Vaginal Pressure; Vaginal Bleeding

Detailed Description:

Preterm Birth is a complex syndrome for which several different biologically plausible pathways have been proposed, including mechanical uterine distension, abruption, inflammation, and/or activation of the fetal hypothalamic-pituitary-axis. However, despite our knowing the complexity of this syndrome and the different pathways involved, there is a paucity of clinical studies investigating whether detection of more than one of these pathways in a single patient might enhance the identification of those at greatest risk for preterm birth. We propose investigating the predictive value of a panel of biomarkers associated with two biological plausible pathways - membrane breakdown and cervical remodeling - that must be involved in the pathogenesis of preterm birth. Specifically, we propose measuring cervical length and collecting cervicovaginal fetal fibronectin as well as a panel of novel cervicovaginal biomarkers that reflect molecular pathways involved in cervical remodeling in a prospectively collected cohort of symptomatic women with singleton fetuses at high risk for preterm birth. Through this study we hope improve risk stratification of this high risk cohort.

Study Design

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Study Type :	Observational
Actual Enrollment :	589 participants
Observational Model:	Cohort
Time Perspective:	Prospective
Official Title:	Screening To Obviate Preterm Birth
Study Start Date :	January 2013
Actual Primary Completion Date :	February 2015
Actual Study Completion Date :	June 2015

Groups and Cohorts

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Group/Cohort
Preterm Labor; Symptomatic women with singleton pregnancy at high risk for preterm birth between 22 - 33 6/7 weeks gestational age. We define "high risk for preterm birth" as women who present to our triage unit with complaints of preterm labor, including but not limited to preterm contractions, abdominal cramping, back pain, vaginal pressure, and vaginal bleeding.

Outcome Measures

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Primary Outcome Measures :

1. Preterm birth [ Time Frame: Enrollment through delivery ]
   The primary outcome is preterm birth defined as delivery before 37 weeks.

Secondary Outcome Measures :

1. Early preterm birth [ Time Frame: Enrollment through delivery ]
   The secondary outcome is "early" preterm birth defined as delivery before 34 weeks.

Biospecimen Retention:   Samples With DNA

A vaginal swab will be collected during the patients clinical admission exam by a nurse.

Eligibility Criteria

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Ages Eligible for Study:	Child, Adult, Senior
Sexes Eligible for Study:	Female
Accepts Healthy Volunteers:	No
Sampling Method:	Non-Probability Sample

Study Population

All pregnant women presenting to the perinatal evaluation center at the Hospital of the University of Pennsylvania with preterm labor symptoms will be approached for the study.

Criteria

Inclusion Criteria:

• Singleton pregnancy between 22- 33 6/7 weeks of gestational age.
• Must be experiencing one ore more of the following symptoms including but not limited to preterm contractions, abdominal cramping, back pain, vaginal pressure, or light vaginal bleeding.

Exclusion Criteria:

• Women with a multi-fetal pregnancy
• Intra uterine fetal demise
• Preterm premature rupture of membranes
• Overt chorioamnionitis

Contacts and Locations

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Locations

United States, Pennsylvania
Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States, 19104

Sponsors and Collaborators

University of Pennsylvania

Hologic, Inc.

Investigators

Principal Investigator:	Michal A Elovitz, MD	University of Pennsylvania

More Information

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Responsible Party:	University of Pennsylvania
ClinicalTrials.gov Identifier:	NCT01868308 History of Changes
Other Study ID Numbers:	817085
First Posted:	June 4, 2013
Last Update Posted:	March 30, 2017
Last Verified:	March 2017

Additional relevant MeSH terms:

Back Pain; Premature Birth; Obstetric Labor, Premature; Uterine Hemorrhage; Pain; Neurologic Manifestations; Nervous System Diseases	Signs and Symptoms; Obstetric Labor Complications; Pregnancy Complications; Uterine Diseases; Genital Diseases, Female; Hemorrhage; Pathologic Processes