Two Year Developmental Follow-up for PREMOD2 Trial (Premature Infants Receiving Milking or Delayed Cord Clamping) (PREMOD2FU)

November 22, 2022 updated by: Sharp HealthCare

Two Year Developmental Follow-up for Premature Infants Receiving Milking or Delayed Cord Clamping: PREMOD2

An extension of the PREMOD2 trial, the PREMOD2 Follow-Up trial will evaluate the neurodevelopmental outcomes at 22-26 months corrected age of preterm children who received UCM or DCC. This prospective multi-national randomized controlled trial (RCT) is a two-arm parallel non-inferiority design of two alternative approaches of treatment.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

The PREMOD2 Follow-up trial will examine the difference in early childhood neurodevelopmental outcomes of subjects enrolled in the PREMOD2 umbilical cord milking (UCM) vs. delayed cord clamping (DCC) trial, using standardized neurologic and developmental assessments at 22-26 months corrected age (CA). The corrected age may be extended out to 42 months CA due to Covid-19 pandemic for undetermined period of time.

Study Type

Interventional

Enrollment (Anticipated)

1200

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Jane Steen, RN
  • Phone Number: 858 939-4114

Study Locations

  • Canada
    • Alberta
      • Edmonton, Alberta, Canada, T6G 2R3
        • Recruiting
        • Governors of University of Alberta
        • Contact:
  • Germany
    • Baden-Wurttemberg
  • Ireland
      • Cork, Ireland
        • Recruiting
        • Cork University Maternity Hospital
        • Contact:
  • United States
    • Alabama
      • Birmingham, Alabama, United States, 35294-0004
    • California
      • Loma Linda, California, United States, 92350
        • Recruiting
        • Loma Linda Medical Center
        • Contact:
      • Los Angeles, California, United States, 90033
        • Recruiting
        • LAC+USC Medical Center
        • Contact:
          • Fiona Wertheimer, DO
          • Phone Number: 323-409-3322
      • Los Angeles, California, United States, 90033
        • Recruiting
        • PIH Health Good Samaritan Hospital
        • Contact:
      • Orange, California, United States, 92868
        • Recruiting
        • University of California, Irvine Medical Center
        • Contact:
      • San Diego, California, United States, 92123
        • Recruiting
        • Sharp Mary Birch Hospital for Women and Newborns
        • Contact:
      • San Diego, California, United States, 91942
    • Delaware
      • Newark, Delaware, United States, 19718
    • Illinois
      • Chicago, Illinois, United States, 60612
    • Mississippi
      • Jackson, Mississippi, United States, 39216
        • Recruiting
        • University of Mississippi Medical Center
        • Contact:
        • Contact:
    • Missouri
    • Ohio
      • Cincinnati, Ohio, United States, 45229
    • Oregon
      • Portland, Oregon, United States, 97225-6603
    • Pennsylvania
      • Pittsburgh, Pennsylvania, United States, 15213
        • Recruiting
        • Magee-Womens Hospital
        • Contact:
    • Utah

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

1 year to 3 years (CHILD)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Children enrolled in the PREMOD2 non-inferiority trial at birth who survive to 2 years corrected age.

Exclusion Criteria:

  • Children enrolled in the PREMOD2 non-inferiority trial at birth who did not survive or are lost to follow-up.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: DIAGNOSTIC
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: QUADRUPLE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
ACTIVE_COMPARATOR: Randomized to Umbilical Cord Milking at birth
Milking the umbilical cord towards the infant at a speed of 20cm/2seconds at birth.
Procedure: Randomized to Umbilical Cord Milking at birth
The subjects in this group were randomized to UCM X4 at birth. This procedure infuses a placental transfusion of blood by milking the umbilical cord towards the infant at birth.
Other Names:
  • UCM
ACTIVE_COMPARATOR: Randomized to Delayed Cord Clamping at birth
Delayed clamping of the umbilical cord at birth.
Procedure: Randomized to Delayed Cord Clamping at birth
The subjects in this group were randomized to DCC at birth. At delivery, the obstetrician was instructed to delay clamping of the umbilical cord for 60 seconds.
Other Names:
  • DCC

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Developmental Outcome
Time Frame: 22-26 months corrected gestational age (CGA). All assessments may be extended to 42 months CGA due to Covid-19 pandemic.
Bayley Scales of Infant Development (BSID), 3rd or 4th Ed. Composite Score (cognitive 55-145, language 45-155, motor 45-155; higher scores are better)
22-26 months corrected gestational age (CGA). All assessments may be extended to 42 months CGA due to Covid-19 pandemic.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Moderate/Severe Neurodevelopmental Impairment
Time Frame: 22-26 months corrected gestational age
Defined having at least one of the following: a cognitive score <70, GMFCS greater or equal 2, blindness (vision <20/200), or hearing impairment interfering with the ability to communicate with amplification.
22-26 months corrected gestational age
Mild Neurodevelopmental Impairment
Time Frame: 22-26 months corrected gestational age
Defined having at least one of the following: a cognitive score 70-84, GMFCS =1, unilateral blindness (vision <20/200 in only one eye), or hearing impairment which does not interfere with the ability to communicate.
22-26 months corrected gestational age
Gross Motor Function Classification System Scale (GMFCS)
Time Frame: 22-26 months corrected gestational age
The GMFCS is a validated system used to describe the severity of motor dysfunction. Scale measured from Level 0-5 with Level 0 being normal and Level 5 being the worst score. Measures ability to walk, sit, head control, voluntary movements and postures.
22-26 months corrected gestational age
Cerebral Palsy (CP)
Time Frame: 22-26 months corrected gestational age
Classified as None, Mild, Moderate or Severe based on GMFCS score; No CP = GMFCS Level 0, Mild CP = GMFCS Level 1, Moderate CP = GMFCS Levels 2-3, Severe CP = GMFCS Levels 4-5
22-26 months corrected gestational age
Developmental Outcomes assessed by Ages & Stages Questionnaire, 3rd ed. (ASQ-3) five domains: Communication, Gross motor, Fine motor, Problem solving and Personal-social in infants born between 23-32+6 weeks GA who received UCM or DCC.
Time Frame: 22-26 months corrected gestational age
Each domain is scored from 0 to 60, the higher score is better.
22-26 months corrected gestational age
Developmental Outcomes in infants born at 23 -27 and 28-32 weeks GA who received UCM or DCC
Time Frame: 22-26 months corrected gestational age
BSID Cognitive, Language & Motor composite scores (cognitive 55-145, language 45-155, motor 45-155; higher scores are better) in infants 23-27 weeks GA and 28-32+6 weeks GA.
22-26 months corrected gestational age
Developmental Outcomes in infants born at 23 -27 and 28-32 weeks GA who received UCM or DCC
Time Frame: 22-26 months corrected gestational age
ASQ-3 scores (0 to 60, the higher score is better) in infants 23-27 weeks GA and 28-32+6 weeks GA.
22-26 months corrected gestational age
Compare levels of developmental impairment as assessed by BSID-3 or 4 versus the ASQ-3 screening tool.
Time Frame: 22-26 months corrected gestational age
Mild, moderate or severe impairment
22-26 months corrected gestational age
Any grade intraventricular hemorrhage (IVH) in premature newborns 23 - 32+6 weeks GA who received UCM or DCC by mode of delivery (C-Section vs vaginal delivery)
Time Frame: From birth through hospital discharge, up to 6 months corrected gestational age (CGA)
Any IVH grade from 1 to grade 4, higher grade is worse
From birth through hospital discharge, up to 6 months corrected gestational age (CGA)
Death in premature newborns 23 - 32+6 weeks GA who received UCM or DCC by mode of delivery (C-Section vs vaginal delivery)
Time Frame: From birth through hospital discharge, up to 6 months corrected gestational age (CGA)
Death
From birth through hospital discharge, up to 6 months corrected gestational age (CGA)
Compare neurodevelopmental outcomes from BSID assessments in newborns 23-32 weeks GA delivered by C-Section with those born by vaginal delivery receiving UCM or DCC.
Time Frame: 22-26 months corrected gestational age
BSID Cognitive, Language & Motor composite scores (cognitive 55-145, language 45-155, motor 45-155; higher scores are better)
22-26 months corrected gestational age
Compare neurodevelopmental outcomes from ASQ assessments in newborns 23-32 weeks GA delivered by C-Section with those born by vaginal delivery receiving UCM or DCC.
Time Frame: 22-26 months corrected gestational age
ASQ-3 scores (0 to 60, the higher score is better).
22-26 months corrected gestational age

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Exploratory, hypothesis-generating
Time Frame: From birth through hospital discharge, up to 6 months corrected gestational age (CGA)
Any grade IVH, from 1 to 4 (higher is worse)
From birth through hospital discharge, up to 6 months corrected gestational age (CGA)
Exploratory, hypothesis-generating
Time Frame: 4 hours of life +/- 2 hours
Hemoglobin or Hematocrit at 4 hours of age
4 hours of life +/- 2 hours
Exploratory, hypothesis-generating
Time Frame: In the first 10 minutes of life
Delivery room interventions received: positive pressure ventilation, continuous positive airway pressure, intubation, chest compressions and medications
In the first 10 minutes of life
Exploratory, hypothesis-generating
Time Frame: In the first 24 hours of life
Blood pressures in the first 24 hours of life: on admission, 6, 12, 18 and 24 hours of life
In the first 24 hours of life

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sharp HealthCare

Collaborators

University of Alabama at Birmingham
University of Pittsburgh
University of Alberta
Christiana Care Health Services
University of California, Irvine
Children's Hospital Medical Center, Cincinnati
University of Utah
Loma Linda University
University of Ulm
University College Cork
Thrasher Research Fund
University of Mississippi Medical Center
St. Louis University
LAC+USC Medical Center
John H. Stroger Hospital
Providence Hospital
Sharp Mary Birch Hospital for Women & Newborns
Sharp Grossmont Hospital
PIH Health Good Samaritan Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

July 6, 2019

Primary Completion (ANTICIPATED)

December 1, 2024

Study Completion (ANTICIPATED)

December 1, 2024

Study Registration Dates

First Submitted

March 19, 2018

First Submitted That Met QC Criteria

March 19, 2018

First Posted (ACTUAL)

March 26, 2018

Study Record Updates

Last Update Posted (ACTUAL)

November 25, 2022

Last Update Submitted That Met QC Criteria

November 22, 2022

Last Verified

November 1, 2022

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PREMOD2 Follow-Up

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Data will be made available per NICHD requirements (National Institute of Child Health and Human Development).

IPD Sharing Time Frame

2 years after primary publication

IPD Sharing Access Criteria

An archived dataset with documentation will be made available for additional uses by outside investigators, in collaboration with the study investigators.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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