Prediction of the Onset of Term and Preterm Labour (PREDICT)
Prediction of the Onset of Term and Preterm Labour (PREDICT)
調査の概要
状態
詳細な説明
Preterm birth is not a single entity but rather multifactorial The mechanisms underlying preterm birth are multifactorial and include stretch, oxidative stress, inflammation, infection and thrombosis. 85% of women have no identifiable risk factors for preterm birth and there is a requirement to develop a biomarker which can be used early in pregnancy to identify such women at risk. Equally important is to have a detection tool which will allow us to offer an individualised approach to preterm birth prevention and the women to benefit personalised surveillance and timely preventative measures such as cervical cerclage or progesterone.
The aim of this study is to collect samples from pregnant women in order to identify biomarkers that relate to onset of spontaneous preterm labour. We will use maternal blood, urine and vaginal secretion to look for biomarkers in these samples which can be use in the clinical setting to determine which women will go on to give birth preterm. This will allow clinicians to correctly identify these women and initiate treatment in the right woman to prevent preterm labour and birth. Equally important it will reduce unnecessary intervention and admission in those women who are not at risk.
研究の種類
入学 (予想される)
連絡先と場所
研究連絡先
- 名前:Research Delivery Operations Manager
- 電話番号:020 3315 6825
- メール:research.development@chewest.nhs.uk
研究連絡先のバックアップ
- 名前:Mark Johnson, MRCOG
- メール:mark.johnson@chelwest.nhs.uk
研究場所
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London、イギリス、SW10 9NH
- 募集
- Chelsea and Westminster Hospital
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コンタクト:
- Research Delivery Operations Manager
- メール:research.development@chelwest.nhs.uk
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主任研究者:
- Natasha Singh, MRCOG
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参加基準
適格基準
就学可能な年齢
- 子
- 大人
- 高齢者
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Group 1 inclusion criteria
- Pregnant woman
- 36 weeks gestational age
Group 1 exclusion criteria
- Risk factors for preterm birth (previous preterm birth or second trimester loss, cervical suture, previous cervical treatment, previous full dilatation caesarean, transabdominal suture).
- Planned Caesarean Section
- Any high-risk pregnancy conditions such as PET (pre-eclamptic toxaemia), OC (Obstetric cholestasis), FGR (fetal growth restriction)
- Unable to read written English
- Unable to provide informed consent
- Poor attendance with antenatal care
- Uncertain gestational age
Exclusion criteria for subset within group 1 using heart rate monitor
- Does not have access to an Apple iPhone or iPad with Bluetooth 4.0 (or later) and iOS 10.0 (or later)
- Skin condition where there is sensitivity to wearing a skin monitor
- Known heart condition or use of a pacemaker
- Taking any medications that may affect heart rate
Group 2 inclusion criteria
- Pregnant woman
- Presenting at or after 24 weeks gestational age and before 36 weeks / Symptoms of threatened preterm labour (abdominal pain) with fetal fibronectin level ≥ 50 ng/mL and without rupture of membranes
- In-utero transfer with suspected threatened preterm labour with evidence of cervical shortening and dilatation with or without a fetal fibronectin
- Rupture of membranes with or without contractions
Group 2 exclusion criteria
- Any high-risk pregnancy conditions such as PET (pre-eclampsia), OC (Obstetric cholestasis), FGR (fetal growth restriction)
- Unable to read written English
- Unable to provide informed consent
- Poor compliance with antenatal care
- Uncertain gestational age
研究計画
研究はどのように設計されていますか?
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
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Group 1
Pregnant women at 36 weeks gestational age, who are not expected to have risk factors for preterm birth, n=150.
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Group 2
Pregnant women who have presented with signs and symptoms of threatened preterm labour (e.g.
ruptured membranes, contractions, bleeding), at or after 24 weeks gestation, n=50.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Relative change in biomarker concentration with respect to gestational age of onset of term and preterm labour
時間枠:Group 1 from 36 weeks until delivery (approximately 6 weeks). Group 2 from admission at or beyond 24 weeks gestation until 42 weeks of gestation if not delivered.
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To use a combination of maternal blood, urine, rectal and vaginal swabs from pregnant to develop a biomarker to allow prediction of women at risk of preterm birth.
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Group 1 from 36 weeks until delivery (approximately 6 weeks). Group 2 from admission at or beyond 24 weeks gestation until 42 weeks of gestation if not delivered.
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Optimal thresholds for each biomarker and estimated associated sensitivity, specificity of each biomarker
時間枠:Group 1 from 36 weeks until delivery (approximately 6 weeks). Group 2 from admission at or beyond 24 weeks gestation until 42 weeks of gestation if not delivered.
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Group 1 from 36 weeks until delivery (approximately 6 weeks). Group 2 from admission at or beyond 24 weeks gestation until 42 weeks of gestation if not delivered.
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Correlation between the percentage of patients with reported demographic variables, lifestyle variables and clinical symptoms
時間枠:Group 1 from 36 weeks until delivery (approximately 6 weeks). Group 2 from admission at or beyond 24 weeks gestation until 42 weeks of gestation if not delivered.
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To determine the correlation between the percentage of patients with reported demographic variables, lifestyle variables and clinical symptoms reported through questionnaires and a daily diary and the onset of preterm birth.
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Group 1 from 36 weeks until delivery (approximately 6 weeks). Group 2 from admission at or beyond 24 weeks gestation until 42 weeks of gestation if not delivered.
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協力者と研究者
捜査官
- 主任研究者:Natasha Singh, MRCOG、Chelsea and Westminster Hospital NHS Foundation Trust
出版物と役立つリンク
一般刊行物
- Ngo TTM, Moufarrej MN, Rasmussen MH, Camunas-Soler J, Pan W, Okamoto J, Neff NF, Liu K, Wong RJ, Downes K, Tibshirani R, Shaw GM, Skotte L, Stevenson DK, Biggio JR, Elovitz MA, Melbye M, Quake SR. Noninvasive blood tests for fetal development predict gestational age and preterm delivery. Science. 2018 Jun 8;360(6393):1133-1136. doi: 10.1126/science.aar3819.
- Heng YJ, Di Quinzio MK, Permezel M, Rice GE, Georgiou HM. Interleukin-1 receptor antagonist in human cervicovaginal fluid in term pregnancy and labor. Am J Obstet Gynecol. 2008 Dec;199(6):656.e1-7. doi: 10.1016/j.ajog.2008.06.011. Epub 2008 Jul 21.
- Heng YJ, Di Quinzio MK, Permezel M, Rice GE, Georgiou HM. Cystatin A protease inhibitor and cysteine proteases in human cervicovaginal fluid in term pregnancy and labor. Am J Obstet Gynecol. 2011 Mar;204(3):254.e1-7. doi: 10.1016/j.ajog.2010.10.912. Epub 2010 Dec 16.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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