- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02400853
Research a New Predictive Marker of Intraventricular Hemorrhage in Very Preterm Infants (HEMO PREMA)
Research a New Predictive Marker of Intraventricular Hemorrhage in Very Preterm Infants: HEMO PREMA Study
The most frequent complications in premature infants are neurological complications: intracranial hemorrhages and white matter lesions. In Epipage 2 study the incidence of severe intraventricular hemorrhages remains stable. Severe hemorrhages are associated with neurological sequelae.
A recent study in humans and in animals shows the role of the complex formed by plasminogen activator (t-PA) and its inhibitor (PAI-1) in the induction of vascular fragility via stromelysin (MMP-3). FIBRINAT study in Rouen University Hospital showed a rate of complex t-PA-PAI1 probably very high in preterm infants. An other factor maturation PDGF-C induced by t-PA is associated with the vascular embrittlement. Among the few genetic factors associated with cerebral palsy include 2 SNP of PAI-1 gene and one SNP in the gene of endothelial NO synthase.
The hypothesis is that a high rate of the complex t-PA-PAI-1 in cord blood could be a high risk of intracranial hemorrhage in preterm infants and provide predictive of their occurrence. The rates of MMP-3, PDGF-C and PAI-1 free in cord blood, and the polymorphism of PAI-1 gene and eNOS could separately or associated with the main criterion to identify predictive of hemorrhages.
The main objective is to search a rate difference of the complex t-PA-PAI-1 in cord blood of preterm infants (before 30 weeks of gestation) that would predict intracranial hemorrhage coming in the first days of life.
The secondary objectives are
- Evaluate potential marker risk of high levels of MMP-3, PAI-1 free, and PDGF-CC
Search in both groups the presence of alleles -675G4 / G5 and 11053 (G / T) of the PAI-1 gene and -922 (A / G) of the eNOS gene.
120 preterm infants will be included before 30 weeks of gestation with precise inclusion and exclusion criteria during a period of 3 years.
Patients will be divided into two groups according to whether they will or not showed intracranial hemorrhage (detected by ultrasound J5-J7).
The complex rate tPA-PAI-1, PAI-1 free, MMP-3 and PDGF-C will be measured. The comparison between the two groups will be carried out using statistical tests. Comparison of the presence of the alleles -675 4G and 11053T the PAI-1 gene or -922G eNOS gene between the two groups will be performed.
The demonstration of this hypothesis would permit to identify children from birth in whom the immediate implementation of preventive treatment of bleeding is desirable.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Lénaïg DONVAL, MD
- Email: lenaig.donval@gmail.com
Study Locations
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-
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Rouen, France, 76031
- Recruiting
- ROUEN university hospital
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Contact:
- Lénaïg DONVAL, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Alive preterm infants between 24 weeks gestation and 29 weeks and 6 days
- Infants of both sexes
- Children whose parents signed a free and informed consent after oral information by one of the study investigators
- Exact term (pregnancy onset evaluated by the craniocaudal length or the date of the puncture in a medical assisted reproduction)
- Children with social protection
Exclusion Criteria:
- Maternal taking of antiplatelet therapy or anticoagulation within 48 hours of birth
- Acquired maternal disease constituting a risk factor for neonatal hemorrhage
- Constitutional maternal disease constituting a risk factor for neonatal hemorrhage
- Severe fetal malformation
- Cesarean birth after diagnosis of hydrocephalus detected in utero
- Minors parents
- History of mental disease,or sensory abnormality of one of the parents, which can lead to confusion about the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: preterm infants with intracranial hemorrhage
Cord blood analysis of preterm infants with radiological finding of intracranial hemorrhage, detected by ultrasound between day 5 and day 7 post-birth (Standard cranial echography) will be collected and analysed
|
Standard cranial echography will be done at day 5 day 7 post-birth looking for radiological finding of intraventricular hemorrhage
Cord blood will be collected during deliverance and analysed
|
Active Comparator: preterm infants without intracranial hemorrhage
Cord blood analysis of preterm infants without radiological finding of intracranial hemorrhage, detected by ultrasound between day 5 and day 7 post-birth (Standard cranial echography) will be collected and analysed
|
Standard cranial echography will be done at day 5 day 7 post-birth looking for radiological finding of intraventricular hemorrhage
Cord blood will be collected during deliverance and analysed
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
tPA-PAI-1 Complex rate in cord blood
Time Frame: day 1
|
tPA-PAI-1 Complex rate in cord blood will be analysed in the 2 groups of infants
|
day 1
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
MMP-3 rate in cord blood
Time Frame: day 1
|
MMP-3 rate in cord blood will be analysed in the 2 groups of infants
|
day 1
|
PAI-1 rate in cord blood
Time Frame: day 1
|
PAI-1 rate in cord blood will be analysed in the 2 groups of infants
|
day 1
|
PDGF-CC rate in cord blood
Time Frame: day 1
|
PDGF-CC rate in cord blood will be analysed in the 2 groups of infants
|
day 1
|
675G4 / G5 G11053T PAI-1 Genetic variations sequencing
Time Frame: day 1
|
Polymorphism of specified sequence will be performed in the 2 groups of infants
|
day 1
|
A-922g eNOS Genetic variations sequencing
Time Frame: day 1
|
Polymorphism of specified sequence will be performed in the 2 groups of infants
|
day 1
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Stéphane MARRET, Pr, UH Rouen
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2014/061/HP
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.
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