- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05404815
Exposure to Plasticisers in the Neonatal Intensive Care Unit (PLASTIC-NICU)
Exposure to Plasticizers in the Neonatal Intensive Care Unit and Long- Term Neurodevelopmental and Pulmonary Toxicity
Study Overview
Status
Detailed Description
RESEARCH HYPOTHESIS: Leaching of plasticizers (DEHP and APs) from indwelling medical devices used in the neonatal intensive care unit (NICU) may expose premature neonates to these chemicals and their metabolites. The resulting exposure may contribute to medical risks and to impaired (neurocognitive) development of the children after hospital discharge.
This project aims to explore scalp hair and urine as a diagnostic tool for exposure to plasticizers in the extremely vulnerable population of premature neonates. The use of scalp hair to detect past exposure is by itself a novel approach and is expected to provide fresh insights into the role of plasticizers in post NICU morbidity. Within this project, we intend to address the following goals to be pursued:
Objective 1. Exploring the use of a non-invasive matrix (scalp hair) to determine past exposure to plasticizers in neonates. By measuring the levels of DEHP and AP metabolites A/ soon after birth in urine and neonatal scalp hair to determine intra-uterine exposure and B/ during follow-up after NICU discharge in infant scalp hair to determine past exposure in NICU (3 months) and early life (12 months).
Objective 2. To study the extent of leaching of plasticizers from indwelling medical devices used in NICU, by A/ determining the ex vivo leaching from the devices in ambient conditions and taking into account acidity and lipid content with relevance for neonatal care and B/ quantifying levels of plasticizers and metabolites in neonatal urine, collected on daily basis upon NICU admission until discharge.
Objective 3. To study the contribution of exposure to plasticizers leaching from indwelling medical devices used in the NICU, to neurocognitive and pulmonary development during the first year of life.
Importance and impact: NICU saves many lives of premature babies, but the long-term consequences of NICU may jeopardize the quality of life. Hence, finding strategies to prevent or attenuate this legacy is crucial. The completion of this project will lead to a comprehensive characterization of the potential health effects arising from leaching of plasticizers currently used in medical devices in NICU.
The study will be carried out in the NICU of the Antwerp University Hospital (UZA), a 28-beds ICU serving as a tertiary reference centre. We will include neonates with a gestational age under 31 weeks and/or birth weight under 1500 grams. We focus on this group of extreme premature neonates, because of their high and prolonged exposure. Board certified neonatologists will prospectively follow up the neonates. All are exposed to a variable number (range 1-6) of a diversity of indwelling medical devices, leading to a variable degree of exposure in the individual neonate. Term born neonates with age, gender and socio-economic status (not admitted to the NICU, n=100) comparable with those of the patients will be recruited as a control group for non-NICU exposure. The study protocol and informed consent forms have already been approved by the UZA Ethical Committee (Ref. 2003022).
Study Type
Enrollment (Actual)
Contacts and Locations
Study Contact
- Name: Lucas Panneel, MD
- Phone Number: +323 265 25 91
- Email: lucas.panneel@uantwerpen.be
Study Locations
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Antwerp
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Edegem, Antwerp, Belgium, 2650
- Antwerp University Hospital - Neonatal Intensive Care Unit
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Preterm NICU neonates: Gestational Age < 31 weeks and/or birth weight < 1500 gram
- Healthy controls: term neonates
Exclusion Criteria:
- Major congenital abnormalities
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Level and sources of NICU exposure to phthalates and alternative plasticizers, measured by liquid chromatography coupled to tandem mass spectrometry in urine samples.
Time Frame: Starting at day 1 postnatal, we collect weekly urine samples, until term age (40 weeks post-menstrual age) or NICU discharge (whatever comes first, up to 120 days postnatally).
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Urine samples are analysed for phthalate and alternative plasticizers' metabolites by liquid chromatography coupled to tandem mass spectrometry at the Antwerp Toxicological Centre.
Results will be described as ng/mL.
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Starting at day 1 postnatal, we collect weekly urine samples, until term age (40 weeks post-menstrual age) or NICU discharge (whatever comes first, up to 120 days postnatally).
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Level and sources of NICU exposure to phthalates and alternative plasticizers, measured by liquid chromatography coupled to tandem mass spectrometry in hair samples.
Time Frame: Scalp hair samples are being collected at term age (37-40 weeks post menstrual age).
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Hair samples are analysed for phthalate and alternative plasticizers' metabolites by liquid chromatography coupled to tandem mass spectrometry at the Antwerp Toxicological Centre.
Results will be described as ng/mg.
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Scalp hair samples are being collected at term age (37-40 weeks post menstrual age).
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Perinatal Morbidity
Time Frame: NICU Discharge (or death, assessed up to 40 weeks post menstrual age)
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Prospective data collection
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NICU Discharge (or death, assessed up to 40 weeks post menstrual age)
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Perinatal Survival
Time Frame: NICU Discharge (or death, assessed up to 40 weeks post menstrual age)
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Prospective data collection
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NICU Discharge (or death, assessed up to 40 weeks post menstrual age)
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Respiratory development - 3 months
Time Frame: 3 months corrected for gestational age
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Respiratory questionnaire
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3 months corrected for gestational age
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Respiratory development - 12 months
Time Frame: 12 months corrected for gestational age
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Respiratory questionnaire
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12 months corrected for gestational age
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Neurodevelopmental outcome - 3 months
Time Frame: 3 months corrected for gestational age
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Bayley Scales of Infant and Toddler Development (BSID III) - Mean score 100 points, standard deviation 15 points.
Higher score corresponds to better outcome
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3 months corrected for gestational age
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Neurodevelopmental outcome - 12 months
Time Frame: 12 months corrected for gestational age
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Bayley Scales of Infant and Toddler Development (BSID III) - Mean score 100 points, standard deviation 15 points.
Higher score corresponds to better outcome
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12 months corrected for gestational age
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Philippe G Jorens, MD, PhD, University Hospital, Antwerp
Publications and helpful links
General Publications
- Lucas Panneel, Govindan Malarvannan, Philippe G. Jorens, Adrian Covaci & Antonius Mulder (2021) Plasticizers in the neonatal intensive care unit: A review on exposure sources and health hazards, Critical Reviews in Environmental Science and Technology, DOI: 10.1080/10643389.2021.1970455
- Panneel L, Cleys P, Breugelmans C, Christia C, Malarvannan G, Poma G, Jorens PG, Mulder A, Covaci A. Neonatal exposure to phthalate and alternative plasticizers via parenteral nutrition. Int J Pharm. 2023 Jan 25;631:122472. doi: 10.1016/j.ijpharm.2022.122472. Epub 2022 Dec 13.
- Cleys P, Panneel L, Bombeke J, Dumitrascu C, Malarvannan G, Poma G, Mulder A, Jorens PG, Covaci A. Hair as an alternative matrix to assess exposure of premature neonates to phthalate and alternative plasticizers in the neonatal intensive care unit. Environ Res. 2023 Nov 1;236(Pt 2):116712. doi: 10.1016/j.envres.2023.116712. Epub 2023 Jul 22.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Mental Disorders
- Respiratory Tract Diseases
- Lung Diseases
- Infant, Newborn, Diseases
- Pregnancy Complications
- Obstetric Labor Complications
- Obstetric Labor, Premature
- Lung Injury
- Infant, Premature, Diseases
- Ventilator-Induced Lung Injury
- Female Urogenital Diseases and Pregnancy Complications
- Urogenital Diseases
- Premature Birth
- Bronchopulmonary Dysplasia
- Neurodevelopmental Disorders
Other Study ID Numbers
- 20/23/022
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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