IMproved PRegnancy Outcome by Early Detection

NCT ID: NCT01891240

Last Updated: 2016-11-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

5000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-11-30

Study Completion Date

2018-04-30

Brief Summary

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The overall objective of the IMPROvED project is to develop a sensitive, specific, high-throughput and economically viable early pregnancy screening test for preeclampsia.

This will involve a multicentre, phase IIa clinical predictive study to assess and refine novel and innovative prototype tests based on emerging metabolomic and proteomic technologies developed by SMEs (small to medium size enterprise) within the consortium. The study will i) recruit 5000 first-time pregnant women; ii) establish a high calibre biobank, augmented by accurate clinical metadata; iii) determine whether prototype predictive assays and algorithms translate to the clinical environment; iv) assess potential synergy of a combined metabolomic and proteomic approach and v) progress regulatory approval and development of the selected test into the clinical arena.

Detailed Description

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Sample size calculations have been considered extensively and given the complexity of the study; there is no single simple solution. For the purpose of sample size estimation in the overall study, we used a binary outcome and associated measures of sensitivity and likelihood ratio as determinants of the value of these tests. Although the predictive algorithms will produce a continuous risk score, the use of a categorical outcome fits with the final binary decision process (to treat or not to treat) based on the risk score. Based on the lowest estimated prevalence of pre-eclampsia of 3% and a test sensitivity of 93% and a test specificity of 97%, then to be 90% certain that the true specificity of the patient population is no less than 95%, a sample size of 4,800 participants is required. Thus, allowing for patient dropout, a study population of 5,000 women is needed.

Conditions

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Pre-eclampsia Pregnancy Pregnancy, High-risk Pregnancy Complications

Keywords

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Diagnostic Pre-eclampsia Pregnancy outcome Mass screening Diagnostic Techniques and Procedures

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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First time, low risk mothers

The study population will consist of first time, low risk mothers attending for antenatal care in one of the participating clinical centres.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Nulliparous.
* Singleton pregnancy, between 9+0 and 16+6 weeks' gestation.
* Signed informed consent.

Exclusion Criteria

* Unsure of last menstrual period (LMP) and unwilling to have ultrasonography screening (USS) at ≤ 20 weeks.
* ≥ 3 miscarriages.
* ≥3 terminations of pregnancy.
* Known or suspected major fetal anomaly/abnormal karyotype.
* Essential hypertension treated pre-pregnancy.
* Moderate-severe hypertension at booking (BP \>160/100 mmHg).
* Diabetes mellitus.
* Renal disease.
* Systemic lupus erythematosus.
* Anti-phospholipid syndrome.
* Sickle cell disease.
* HIV positive.
* Hepatitis B or C positive.
* Major uterine anomaly.
* Cervical suture in situ.
* Knife cone biopsy.
* Long-term steroids.
* Treatment with low-dose aspirin.
* Treatment with heparin/LMW heparin.
* Lack of informed consent.

After recruitment, if the woman is found to be outside the stated gestation limits for the IMPROvED 1st visit of 9 weeks 0 days to 13 weeks 6 days she will be retained in the study if she is willing to take part in the second and third visit and is otherwise eligible. There is one pre-specified criteria for discontinuation of a participant. If a woman is recruited into the IMPROvED study and later identified as having a pregnancy exclusion criterion, i.e., ≥ 3 miscarriages, ≥ 3 TOPS, or using low-dose aspirin at the time of recruitment, she shall be excluded. However, women diagnosed during the pregnancy but after recruitment with an exclusion criterion, e.g., diseases such as renal disease, anti-phospholipid syndrome, etc. shall be retained within the study. Women who are recruited but later discontinue from the study do not count towards recruitment targets for each centre. Accordingly, such dropouts must be replaced.
Minimum Eligible Age

16 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Keele University

OTHER

Sponsor Role collaborator

University of Liverpool

OTHER

Sponsor Role collaborator

Karolinska University

OTHER

Sponsor Role collaborator

Erasmus Medical Center

OTHER

Sponsor Role collaborator

Copenhagen Trial Unit, Center for Clinical Intervention Research

OTHER

Sponsor Role collaborator

MedSciNet AB, Stockholm, Sweden

UNKNOWN

Sponsor Role collaborator

MyCartis, Ghent, Belgium

UNKNOWN

Sponsor Role collaborator

Metabolomic Diagnostics Ltd, Cork, Ireland

UNKNOWN

Sponsor Role collaborator

Accelopment AG

OTHER

Sponsor Role collaborator

University of Groningen, The Netherlands

UNKNOWN

Sponsor Role collaborator

INFANT centre, University College Cork, Republic of Ireland

UNKNOWN

Sponsor Role collaborator

Louise Kenny

OTHER

Sponsor Role lead

Responsible Party

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Louise Kenny

Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Louise Kenny, Professor

Role: PRINCIPAL_INVESTIGATOR

INFANT Centre, University College Cork, Ireland

Philip N Baker, Professor

Role: PRINCIPAL_INVESTIGATOR

Keele Univeristy School of Medicine

Locations

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Cork University Maternity Hospital, University College Cork

Wilton, Cork, Ireland

Site Status RECRUITING

Erasmus Medical Center Rotterdam

Rotterdam, , Netherlands

Site Status RECRUITING

Karolinska University Hospital Huddinge, Karolinska Institute

Stockholm, , Sweden

Site Status RECRUITING

Liverpool Women's Hospital, University of Liverpool

Liverpool, Merseyside, United Kingdom

Site Status RECRUITING

Keele University School of Medicine, Shrewsbury and Telford Hospital NHS Trust

Shrewsbury, Shropshire, United Kingdom

Site Status COMPLETED

Keele University School of Medicine, University Hospital of North Midlands

Stoke-on-Trent, Staffordshire, United Kingdom

Site Status COMPLETED

Countries

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Germany Ireland Netherlands Sweden United Kingdom

Facility Contacts

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Louise Kenny

Role: primary

Hans Duvekot

Role: primary

Karolina Kublickiene

Role: primary

Zarko Alfirevic

Role: primary

References

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McCarthy EK, Schneck D, Basu S, Xenopoulos-Oddsson A, McCarthy FP, Kiely ME, Georgieff MK. Longitudinal evaluation of iron status during pregnancy: a prospective cohort study in a high-resource setting. Am J Clin Nutr. 2024 Nov;120(5):1259-1268. doi: 10.1016/j.ajcnut.2024.08.010. Epub 2024 Sep 26.

Reference Type DERIVED
PMID: 39510727 (View on PubMed)

Navaratnam K, Alfirevic Z, Baker PN, Gluud C, Gruttner B, Kublickiene K, Zeeman G, Kenny LC. A multi-centre phase IIa clinical study of predictive testing for preeclampsia: improved pregnancy outcomes via early detection (IMPROvED). BMC Pregnancy Childbirth. 2013 Dec 7;13:226. doi: 10.1186/1471-2393-13-226.

Reference Type DERIVED
PMID: 24314209 (View on PubMed)

Related Links

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http://www.fp7-improved.eu/

Official website of IMPROvED

Other Identifiers

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Project no: 305169

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

Study Protocol v. 8.0 20122013

Identifier Type: -

Identifier Source: org_study_id