- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04721912
Group B Streptococcus Response After Probiotic Exposure (GRAPE)
May 13, 2024 updated by: Katrina A. Nardini, University of New Mexico
Open-label Randomized Control Trial and Feasibility Study of Florjajen Digestion Probiotics to Reduce GBS Colonization in Pregnant Women by the Time of Birth.
This is an open-label randomized control trial and feasibility study designed to determine the feasibility of a larger RCT in our setting that would examine prenatal probiotic use in Group B Strep (GBS) positive pregnant women at term.
Investigators hope to address the question of whether prenatal oral probiotic use, taken by healthy low risk GBS positive women from approximately 37 weeks gestation until the time of birth, will reduce the number of women who test positive for GBS at the time of admission to Labor and Delivery (L&D).
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
This is an open-label randomized control trial and feasibility study designed to determine the feasibility of a larger RCT in our setting that would examine prenatal probiotic use in Group B Strep (GBS) positive pregnant women at term.
We hope to address the question of whether prenatal oral probiotic use, taken by healthy low risk GBS positive women from approximately 37 weeks gestation until the time of birth, will reduce the number of women who test positive for GBS at the time of admission to Labor and Delivery (L&D).
In this study we aim to determine whether such a study is acceptable in our population, whether any adverse events are identified, and what barriers or confounding variables might exist to probiotic use at term.
We will also look at whether probiotic use had any reported effect on maternal gastrointestinal (GI) symptoms.
Study Type
Interventional
Enrollment (Actual)
68
Phase
- Phase 3
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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New Mexico
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Albuquerque, New Mexico, United States, 87112
- University of New Mexico Hospital
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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
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
• Healthy adult (≥ 18 years of age) pregnant women who are 36 - 37 6/7 weeks gestation at enrollment [calculated from the first day of Last Normal Menstrual Period (LNMP) and/or ultrasound (US)]
Group B Streptococcus Positive at 36 weeks gestation with:
- No obstetric complication requiring delivery prior to 39 weeks (hypertensive disorder diagnosed prior to enrollment, gestational diabetes, multiple gestation)
- No fetal complication (e.g., birth defect, intrauterine growth restriction)
- No medical complication (e.g., chronic hypertension, preexisting diabetes mellitus)
- Who do not currently ingest an over the counter probiotic supplement (not including yogurt)
- Who can both speak and read English or Spanish
- Pregnant women who regularly attend UNM prenatal clinics for their prenatal care ("regularly attend" will be defined as starting prenatal care prior to 20 weeks gestation and missing no more than one prenatal appointment during this pregnancy)
- No hypersensitivity reaction to β-lactam antibiotics
Exclusion Criteria:
- Those less than 18 years of age
- Non-pregnant women
- Later in pregnancy than 38 weeks gestation at enrollment [per LNMP and/or US]
- Those with an obstetric, fetal or medical complication of pregnancy
- Group B Streptococcus negative at 36 weeks gestation. Those ineligible for testing at 36 weeks gestation (history of GBS bacteriuria during the current pregnancy or have previously given birth to a GBS affected child.) We will not exclude those with bacteriuria other than GBS, and we will not exclude women who have taken an antibiotic during pregnancy, but we will track this as it is addressed in the Questionnaire for Women.
- Women who are currently ingesting an over the counter probiotic supplement (except for yogurt)
- Women who do not have electricity in the home.
- Women who are planning an elective repeat cesarean birth
- Women who do not speak and read English or Spanish
- Women with a history of missing one or more scheduled prenatal visit during this pregnancy
- Hypersensitivity reaction to β-lactam antibiotics
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: Treatment
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Standard of Care
Subjects in the control group will not receive any Probiotic capsules and will be advised to continue their routine prenatal self-care.
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Experimental: Probiotic Dietary Supplement
Participants in the intervention group will begin taking oral study Probiotic capsules once daily from time of enrollment/randomization at ≥ 36 weeks gestation until the time of birth.
The research staff member will sequentially distribute the pre-labeled bottles of study capsules to the intervention group, one bottle of 30 Florajen Digestion probiotic capsules to women in the intervention group at the time of randomization.
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GBS positive patients, at ≥ 36 weeks gestation, will begin taking oral Florajen Digestion probiotic capsules once daily from time of enrollment/randomization at ≥ 36 weeks gestation until the time of birth.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
GBS culture result (positive versus negative)
Time Frame: 36 - 42 weeks gestational age (admission to Labor and Delivery)
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Qualitative GBS colonization (positive versus negative), at the time of admission to Labor and Delivery.
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36 - 42 weeks gestational age (admission to Labor and Delivery)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Probiotic pill count to measure intervention adherence
Time Frame: Postpartum (day 0-14)
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Intervention adherence by pill count for probiotic participants
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Postpartum (day 0-14)
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Antepartum Gastrointestinal Symptom Assessment (AP-GI-SA) score
Time Frame: Baseline (36-37.6 weeks gestational age) and postpartum (day 0-14)
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Maternal gastrointestinal (GI) symptoms based on AP-GI-SA score: lowest score 10, highest score 50 (high score means more symptoms = worse outcome)
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Baseline (36-37.6 weeks gestational age) and postpartum (day 0-14)
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Number of participants who report adverse events
Time Frame: Weekly prenatal visits starting at time of enrollment until time of delivery (37-42 weeks gestational age and 2 weeks and 6 weeks postpartum visits)
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Maternal adverse events by organ system and severity
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Weekly prenatal visits starting at time of enrollment until time of delivery (37-42 weeks gestational age and 2 weeks and 6 weeks postpartum visits)
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Number of participants who report adverse events in their infant
Time Frame: 2 weeks and 6 weeks postpartum visits
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Infant adverse events by organ system and severity
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2 weeks and 6 weeks postpartum visits
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Katrina Nardini, University of New Mexico
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)
December 24, 2020
Primary Completion (Actual)
August 31, 2023
Study Completion (Actual)
August 31, 2023
Study Registration Dates
First Submitted
December 7, 2020
First Submitted That Met QC Criteria
January 19, 2021
First Posted (Actual)
January 25, 2021
Study Record Updates
Last Update Posted (Estimated)
May 15, 2024
Last Update Submitted That Met QC Criteria
May 13, 2024
Last Verified
May 1, 2024
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 20-396
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
Yes
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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