Longitudinal Study of Intra-Uterine Growth Restriction
Longitudinal Study of Intra-Uterine Growth Restriction (IUGR)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Emma Peek, BS
- Email: emma.peek@cuanschutz.edu
Study Locations
-
-
Colorado
-
Aurora, Colorado, United States, 80045
- Recruiting
- University of Colorado Denver Anschutz Medical Campus
-
Contact:
- Emma Peek, BS
- Email: emma.peek@cuanschutz.edu
-
Sub-Investigator:
- Sharon Hunter, PhD
-
Sub-Investigator:
- Naila Naushad, MBBS
-
Sub-Investigator:
- Jilliam Ellerman
-
Sub-Investigator:
- Diane Gumina, PhD
-
Sub-Investigator:
- Thomas Jansson, MD PhD
-
Sub-Investigator:
- Theresa Powell, PhD
-
Sub-Investigator:
- Lorna Moore, PhD
-
Sub-Investigator:
- Emily Su, MD MSCI
-
Sub-Investigator:
- Emma Peek, BS
-
Sub-Investigator:
- Colleen Julian, PhD
-
Principal Investigator:
- John Hobbins, MD
-
Sub-Investigator:
- Henry Galan, MD
-
Sub-Investigator:
- Mike Zaretsky, MD
-
Sub-Investigator:
- Shane Reeves, MD
-
Sub-Investigator:
- Bettina Cuneo, MD
-
Sub-Investigator:
- Lisa Howley, MD
-
Sub-Investigator:
- David Mirsky, MD
-
Sub-Investigator:
- Mariana Meyers, MD
-
Sub-Investigator:
- Jennifer Armstrong-Wells, MD
-
Sub-Investigator:
- Laura Brown, MD
-
Sub-Investigator:
- Miriam Post, MD
-
Sub-Investigator:
- Sean Deoni, MD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients with diagnosed SGA by an ultrasound estimated fetal weight (EFW) of less than the 10th percentile or a fetal abdominal circumference of less than the 5th percentile will be included in the study at the time of their first examination.
Exclusion Criteria:
- Patients < 18 years of age, and chromosomal anomalies as identified by regular aneuploidy screening.
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Control
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Small for Gestational Age Pregancies (controls)
Small for gestational age (SGA) pregnancies that do not develop IUGR will be considered controls.
Each subject will have an ultrasound, MRI, maternal blood and cord blood collection, placental analysis, neurological function assessments (infant), and body fat measurements (infant).
|
With 3-D and 4-D high-resolution color Doppler methods it is possible to map out the placental circulation, fetal circulation, fetal brain, and fetal cardiac function.
Investigators will collect these data points prenatally.
Similar to the Ultrasound data, investigators will collect MRI images of the fetal brain and the placenta.
MRI will allow investigators to collect more detailed images of both the fetal brain and placenta, and investigators will be utilizing this technique both prenatally and postnatally.
The maternal and cord blood will be collected for the processing of plasma and serum.
There may be early biomarkers of IUGR in the maternal circulation that investigators can use to better determine the appropriate strategy for clinical management of care.
Collection and subsequent analysis of molecular markers in the umbilical cord blood will be used to further confirm physiological dysfunction as detected by ultrasound and MRI techniques.
Placentas will undergo pathological evaluation for placental function.
The baby's body fat will be measured in a special incubator called a PEAPOD or BODPOD when an infant.
Other Names:
Neurological development tests including a Bayley exam, Mullen exam, Developmental Profile-3, Child Behavior Checklist, and Pediatric Stroke Outcome Measure (PSOM) will be performed.
Children will have ultrasounds of their hearts during follow-up visits.
|
|
IUGR Pregnancies (cases)
Small for gestational age (SGA) pregnancies that do develop IUGR will be considered cases.
Each subject will have an ultrasound, MRI, maternal blood and cord blood collection, placental analysis, neurological function assessments (infant), and body fat measurements (infant).
|
With 3-D and 4-D high-resolution color Doppler methods it is possible to map out the placental circulation, fetal circulation, fetal brain, and fetal cardiac function.
Investigators will collect these data points prenatally.
Similar to the Ultrasound data, investigators will collect MRI images of the fetal brain and the placenta.
MRI will allow investigators to collect more detailed images of both the fetal brain and placenta, and investigators will be utilizing this technique both prenatally and postnatally.
The maternal and cord blood will be collected for the processing of plasma and serum.
There may be early biomarkers of IUGR in the maternal circulation that investigators can use to better determine the appropriate strategy for clinical management of care.
Collection and subsequent analysis of molecular markers in the umbilical cord blood will be used to further confirm physiological dysfunction as detected by ultrasound and MRI techniques.
Placentas will undergo pathological evaluation for placental function.
The baby's body fat will be measured in a special incubator called a PEAPOD or BODPOD when an infant.
Other Names:
Neurological development tests including a Bayley exam, Mullen exam, Developmental Profile-3, Child Behavior Checklist, and Pediatric Stroke Outcome Measure (PSOM) will be performed.
Children will have ultrasounds of their hearts during follow-up visits.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Characterize the sequence of neurological and cardiovascular events defining early and late IUGR pathogenesis, respectively
Time Frame: Every two weeks from the time of IUGR diagnosis or first visit
|
Using ultrasound and MRI to identify changes in the fetal vasculature, and fetal brain as early and late IUGR progress.
|
Every two weeks from the time of IUGR diagnosis or first visit
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Correlate in utero adaptations in early and late IUGR, to infant and early childhood neurodevelopment
Time Frame: Baseline (Day 0), 40-44 weeks gestational age (post-birth), 6 months, 1-7 years
|
Assess neurodevelopment with a series of tests (PSOM, Bayleys III, Mullen's Scale of Early Learning, Developmental Profile-3, Child Behavior Checklist) and correlate neurological in utero findings to neurodevelopment outcomes after birth.
|
Baseline (Day 0), 40-44 weeks gestational age (post-birth), 6 months, 1-7 years
|
|
Correlate in utero adaptations in early and late IUGR, to infant and early childhood cardiovascular outcomes
Time Frame: Baseline (Day 0), 40-44 weeks gestational age (post-birth), 6 months, 1-7 years
|
Assess cardiovascular health via heart ultrasound after birth
|
Baseline (Day 0), 40-44 weeks gestational age (post-birth), 6 months, 1-7 years
|
|
Correlate in utero adaptations in early and late IUGR, to infant and early childhood metabolic outcomes
Time Frame: Baseline (Day 0), 40-44 weeks gestational age (post-birth), 6 months, 1-7 years
|
Correlate IUGR severity to metabolic outcomes as assessed by body composition (pea pod and bod pod with a pediatric attachment), anthropometrics, and a diet questionnaire after birth.
|
Baseline (Day 0), 40-44 weeks gestational age (post-birth), 6 months, 1-7 years
|
|
Compare early IUGR, late IUGR and SGA infant and early childhood outcomes
Time Frame: Baseline (Day 0), 40-44 weeks gestational age (post-birth), 6 months, 1-7 years
|
Using the tests describe above compare the outcomes of each group after birth.
|
Baseline (Day 0), 40-44 weeks gestational age (post-birth), 6 months, 1-7 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: John Hobbins, MD, University of Colorado, Denver
Publications and helpful links
General Publications
- Odibo AO, Zhong Y, Longtine M, Tuuli M, Odibo L, Cahill AG, Macones GA, Nelson DM. First-trimester serum analytes, biophysical tests and the association with pathological morphometry in the placenta of pregnancies with preeclampsia and fetal growth restriction. Placenta. 2011 Apr;32(4):333-8. doi: 10.1016/j.placenta.2011.01.016. Epub 2011 Feb 13.
- Ferrazzi E, Bozzo M, Rigano S, Bellotti M, Morabito A, Pardi G, Battaglia FC, Galan HL. Temporal sequence of abnormal Doppler changes in the peripheral and central circulatory systems of the severely growth-restricted fetus. Ultrasound Obstet Gynecol. 2002 Feb;19(2):140-6. doi: 10.1046/j.0960-7692.2002.00627.x.
- Hecher K, Bilardo CM, Stigter RH, Ville Y, Hackeloer BJ, Kok HJ, Senat MV, Visser GH. Monitoring of fetuses with intrauterine growth restriction: a longitudinal study. Ultrasound Obstet Gynecol. 2001 Dec;18(6):564-70. doi: 10.1046/j.0960-7692.2001.00590.x.
- Egana-Ugrinovic G, Sanz-Cortes M, Figueras F, Bargallo N, Gratacos E. Differences in cortical development assessed by fetal MRI in late-onset intrauterine growth restriction. Am J Obstet Gynecol. 2013 Aug;209(2):126.e1-8. doi: 10.1016/j.ajog.2013.04.008. Epub 2013 Apr 9.
- Barker ED, McAuliffe FM, Alderdice F, Unterscheider J, Daly S, Geary MP, Kennelly MM, O'Donoghue K, Hunter A, Morrison JJ, Burke G, Dicker P, Tully EC, Malone FD. The role of growth trajectories in classifying fetal growth restriction. Obstet Gynecol. 2013 Aug;122(2 Pt 1):248-254. doi: 10.1097/AOG.0b013e31829ca9a7.
- Mongelli M, Gardosi J. Reduction of false-positive diagnosis of fetal growth restriction by application of customized fetal growth standards. Obstet Gynecol. 1996 Nov;88(5):844-8. doi: 10.1016/0029-7844(96)00285-2.
- Cruz-Martinez R, Figueras F, Hernandez-Andrade E, Puerto B, Gratacos E. Longitudinal brain perfusion changes in near-term small-for-gestational-age fetuses as measured by spectral Doppler indices or by fractional moving blood volume. Am J Obstet Gynecol. 2010 Jul;203(1):42.e1-6. doi: 10.1016/j.ajog.2010.02.049. Epub 2010 May 1.
- Turan OM, Turan S, Berg C, Gembruch U, Nicolaides KH, Harman CR, Baschat AA. Duration of persistent abnormal ductus venosus flow and its impact on perinatal outcome in fetal growth restriction. Ultrasound Obstet Gynecol. 2011 Sep;38(3):295-302. doi: 10.1002/uog.9011.
- Acharya G. Measurement of atrioventricular annular plane displacement has been revived: will it prove to be useful in assessing fetal cardiac function? Ultrasound Obstet Gynecol. 2013 Aug;42(2):125-9. doi: 10.1002/uog.12542. No abstract available.
- Kiserud T. Re: umbilical vein flow and perinatal outcome in term small-for-gestational-age fetuses. M. Parra-Saavedra, F. Crovetto, S. Triunfo, S. Savchev, G. Parra, M. Sanz, E. Gratacos and F. Figueras. Ultrasound Obstet Gynecol 2013; 42: 189-195. Ultrasound Obstet Gynecol. 2013 Aug;42(2):130. doi: 10.1002/uog.12553. No abstract available.
- Hafner E, Metzenbauer M, Stumpflen I, Waldhor T. Measurement of placental bed vascularization in the first trimester, using 3D-power-Doppler, for the detection of pregnancies at-risk for fetal and maternal complications. Placenta. 2013 Oct;34(10):892-8. doi: 10.1016/j.placenta.2013.06.303. Epub 2013 Jul 24.
- Figueras F, Cruz-Martinez R, Sanz-Cortes M, Arranz A, Illa M, Botet F, Costas-Moragas C, Gratacos E. Neurobehavioral outcomes in preterm, growth-restricted infants with and without prenatal advanced signs of brain-sparing. Ultrasound Obstet Gynecol. 2011 Sep;38(3):288-94. doi: 10.1002/uog.9041. Epub 2011 Aug 10.
- Eixarch E, Meler E, Iraola A, Illa M, Crispi F, Hernandez-Andrade E, Gratacos E, Figueras F. Neurodevelopmental outcome in 2-year-old infants who were small-for-gestational age term fetuses with cerebral blood flow redistribution. Ultrasound Obstet Gynecol. 2008 Dec;32(7):894-9. doi: 10.1002/uog.6249.
- Fowlkes JB, Holland CK. Mechanical bioeffects from diagnostic ultrasound: AIUM consensus statements. American Institute of Ultrasound in Medicine. J Ultrasound Med. 2000 Feb;19(2):69-72. doi: 10.7863/jum.2000.19.2.69. No abstract available.
- Torloni MR, Vedmedovska N, Merialdi M, Betran AP, Allen T, Gonzalez R, Platt LD; ISUOG-WHO Fetal Growth Study Group. Safety of ultrasonography in pregnancy: WHO systematic review of the literature and meta-analysis. Ultrasound Obstet Gynecol. 2009 May;33(5):599-608. doi: 10.1002/uog.6328.
- Ang ES Jr, Gluncic V, Duque A, Schafer ME, Rakic P. Prenatal exposure to ultrasound waves impacts neuronal migration in mice. Proc Natl Acad Sci U S A. 2006 Aug 22;103(34):12903-10. doi: 10.1073/pnas.0605294103. Epub 2006 Aug 10.
- Salvesen KA, Eik-Nes SH. Ultrasound during pregnancy and subsequent childhood non-right handedness: a meta-analysis. Ultrasound Obstet Gynecol. 1999 Apr;13(4):241-6. doi: 10.1046/j.1469-0705.1999.13040241.x.
- Newnham JP, Doherty DA, Kendall GE, Zubrick SR, Landau LL, Stanley FJ. Effects of repeated prenatal ultrasound examinations on childhood outcome up to 8 years of age: follow-up of a randomised controlled trial. Lancet. 2004 Dec 4-10;364(9450):2038-44. doi: 10.1016/S0140-6736(04)17516-8.
- Schwartz JL, Crooks LE. NMR imaging produces no observable mutations or cytotoxicity in mammalian cells. AJR Am J Roentgenol. 1982 Sep;139(3):583-5. doi: 10.2214/ajr.139.3.583. No abstract available.
- Thomas A, Morris PG. The effects of NMR exposure on living organisms. I. A microbial assay. Br J Radiol. 1981 Jul;54(643):615-21. doi: 10.1259/0007-1285-54-643-615.
- Baker PN, Johnson IR, Harvey PR, Gowland PA, Mansfield P. A three-year follow-up of children imaged in utero with echo-planar magnetic resonance. Am J Obstet Gynecol. 1994 Jan;170(1 Pt 1):32-3. doi: 10.1016/s0002-9378(94)70379-5.
- Simon EM, Goldstein RB, Coakley FV, Filly RA, Broderick KC, Musci TJ, Barkovich AJ. Fast MR imaging of fetal CNS anomalies in utero. AJNR Am J Neuroradiol. 2000 Oct;21(9):1688-98.
- Runge VM. Safety of approved MR contrast media for intravenous injection. J Magn Reson Imaging. 2000 Aug;12(2):205-13. doi: 10.1002/1522-2586(200008)12:23.0.co;2-p.
- Victoria T, Jaramillo D, Roberts TP, Zarnow D, Johnson AM, Delgado J, Rubesova E, Vossough A. Fetal magnetic resonance imaging: jumping from 1.5 to 3 tesla (preliminary experience). Pediatr Radiol. 2014 Apr;44(4):376-86; quiz 373-5. doi: 10.1007/s00247-013-2857-0. Epub 2014 Mar 27.
- Savchev S, Figueras F, Cruz-Martinez R, Illa M, Botet F, Gratacos E. Estimated weight centile as a predictor of perinatal outcome in small-for-gestational-age pregnancies with normal fetal and maternal Doppler indices. Ultrasound Obstet Gynecol. 2012 Mar;39(3):299-303. doi: 10.1002/uog.10150. Epub 2012 Feb 7.
- Chawengsettakul S, Russameecharoen K, Wanitpongpan P. Fetal cardiac function measured by myocardial performance index of small-for-gestational age fetuses. J Obstet Gynaecol Res. 2015 Feb;41(2):222-8. doi: 10.1111/jog.12508. Epub 2014 Aug 27.
- Mailath-Pokorny M, Worda K, Schmid M, Polterauer S, Bettelheim D. Isolated single umbilical artery: evaluating the risk of adverse pregnancy outcome. Eur J Obstet Gynecol Reprod Biol. 2015 Jan;184:80-3. doi: 10.1016/j.ejogrb.2014.11.007. Epub 2014 Nov 20.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Fetal Diseases
- Pregnancy Complications
- Growth Disorders
- Female Urogenital Diseases and Pregnancy Complications
- Urogenital Diseases
- Fetal Growth Retardation
- Investigative Techniques
- Specimen Handling
- Clinical Laboratory Techniques
- Diagnostic Techniques and Procedures
- Diagnosis
- Punctures
- Surgical Procedures, Operative
- Physical Phenomena
- Radiation
- Radiation, Nonionizing
- Ultrasonic Waves
- Sound
- Blood Specimen Collection
- High-Energy Shock Waves
- PEAPOD protein, Arabidopsis
Other Study ID Numbers
Other Study ID Numbers
- 14-1360
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.