Melatonin to Prevent Brain Injury in Unborn Growth Restricted Babies
A Pilot Study of Maternally Administered Melatonin to Decrease the Level of Oxidative Stress in Human Pregnancies Affected by Intrauterine Growth Restriction.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
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Victoria
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Clayton, Victoria, Australia, 3168
- Southern Health: Monash Medical Centre and Jessie McPherson Private Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Estimated fetal weight <10th percentile in combination with abnormal fetoplacental Doppler studies.
- Singleton pregnancy.
- Live fetus.
- Gestational age: from 23+0 weeks until 34+0 weeks.
- Normal fetal anatomy on ultrasound.
- Confirmed gestational age.
- No indication for immediate delivery.
- Basic understanding of the English language.
- 18 years or older.
- Consent obtained.
Exclusion Criteria:
- Fetal demise.
- Multiple pregnancy.
- Known abnormal karyotype.
- Presence of any congenital abnormality.
- Unknown duration of pregnancy.
- IUGR attributable to non-placental factors.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Melatonin
Women with IUGR will take 4mg prolonged release melatonin oral tablets twice daily.
Treatment will occur as soon as the diagnosis of intrauterine growth restriction is made and the patient has been enrolled to this study until birth.
The overall duration of treatment will vary due to the nature of intrauterine growth restriction.
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4mg prolonged release melatonin oral tablets twice daily
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Oxidative stress in the umbilical artery
Time Frame: Once, at birth.
|
Umbilical artery oxidative stress by measuring levels of malondialdehyde (MDA) and 8-isoprostane.
Levels of MDA will be assessed using a Thiobarbituric Acid Reactive Substances Assay Kit (Cayman Chemical Item Number 10009055).
Levels of 8-isoprostane will be assessed using an 8-Isoprostane Enzyme Immuno Assay Kit (Cayman Chemical Item Number 516351).
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Once, at birth.
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Oxidative stress in maternal venous serum
Time Frame: Once within one week before start treatment and once per week during the treatment period (estimated to be an average of 4 weeks).
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Maternal serum oxidative stress will be assessed by measuring levels of malondialdehyde (MDA) and 8-isoprostane.
Levels of MDA will be assessed using a Thiobarbituric Acid Reactive Substances Assay Kit (Cayman Chemical Item Number 10009055).
Levels of 8-isoprostane will be assessed using an 8-Isoprostane Enzyme Immuno Assay Kit (Cayman Chemical Item Number 516351).
|
Once within one week before start treatment and once per week during the treatment period (estimated to be an average of 4 weeks).
|
|
Fetoplacental Doppler studies
Time Frame: Once within one week before start treatment and twice per week during the treatment period (estimated to be an average of 4 weeks).
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Fetoplacental Doppler studies (umbilical artery, uterine artery, middle cerebral artery, ductus venosus).
Fetoplacental Doppler studies are performed in the clinical assessment of women diagnosed with intrauterine growth restriction by sonography.
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Once within one week before start treatment and twice per week during the treatment period (estimated to be an average of 4 weeks).
|
|
Placental oxidative stress
Time Frame: Once, at birth.
|
Placental oxidative stress is assessed by measuring levels of malondialdehyde (MDA) and 8-isoprostane.
Levels of MDA will be assessed using a Thiobarbituric Acid Reactive Substances Assay Kit (Cayman Chemical Item Number 10009055).
Levels of 8-isoprostane will be assessed using an 8-Isoprostane Enzyme Immuno Assay Kit (Cayman Chemical Item Number 516351)
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Once, at birth.
|
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Gestational age at birth.
Time Frame: Once, at birth.
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Gestational age at birth will be calculated using the last menstrual period and ultrasound characteristics.
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Once, at birth.
|
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Composite neonatal outcome.
Time Frame: Participants will be followed for the duration of hospital stay, up to 12 months.
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Composite neonatal outcome (admission to NICU, duration of admission, need and duration of respiratory support, intraventricular haemorrhage, necrotising enterocolitis, abnormal neurological assessment, mortality before discharge).
This composite neonatal outcome will be measured by collecting medical record data after clinical assessments.
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Participants will be followed for the duration of hospital stay, up to 12 months.
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Nicole O Alers, MD, The Ritchie Centre, Monash Institute of Medical Research, Monash University
- Principal Investigator: Euan M Wallace, MBChB MD FRCOG FRANZCOG, Southern Health, The Ritchie Centre, Monash Institute of Medical Research, Monash University
- Principal Investigator: Graham Jenkin, BSc PhD, The Ritchie Centre, Monash Institute of Medical Research
- Principal Investigator: Suzanne L Miller, BSc PhD, The Ritchie Centre, Monash Institute of Medical Research
Publications and helpful links
General Publications
- Miller SL, Yawno T, Alers NO, Castillo-Melendez M, Supramaniam VG, VanZyl N, Sabaretnam T, Loose JM, Drummond GR, Walker DW, Jenkin G, Wallace EM. Antenatal antioxidant treatment with melatonin to decrease newborn neurodevelopmental deficits and brain injury caused by fetal growth restriction. J Pineal Res. 2014 Apr;56(3):283-94. doi: 10.1111/jpi.12121. Epub 2014 Feb 22.
- Alers NO, Jenkin G, Miller SL, Wallace EM. Antenatal melatonin as an antioxidant in human pregnancies complicated by fetal growth restriction--a phase I pilot clinical trial: study protocol. BMJ Open. 2013 Dec 23;3(12):e004141. doi: 10.1136/bmjopen-2013-004141.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- U1111-1133-4541
- ACTRN12612000858897 (Registry Identifier: Australian New Zealand Clinical Trial Registry)
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