Research a New Predictive Marker of Intraventricular Hemorrhage in Very Preterm Infants
NCT ID: NCT02400853
Last Updated: 2016-12-07
Study Results
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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UNKNOWN
NA
120 participants
INTERVENTIONAL
2015-07-31
2018-08-31
Brief Summary
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A recent study in humans and in animals shows the role of the complex formed by plasminogen activator (t-PA) and its inhibitor (PAI-1) in the induction of vascular fragility via stromelysin (MMP-3). FIBRINAT study in Rouen University Hospital showed a rate of complex t-PA-PAI1 probably very high in preterm infants. An other factor maturation PDGF-C induced by t-PA is associated with the vascular embrittlement. Among the few genetic factors associated with cerebral palsy include 2 SNP of PAI-1 gene and one SNP in the gene of endothelial NO synthase.
The hypothesis is that a high rate of the complex t-PA-PAI-1 in cord blood could be a high risk of intracranial hemorrhage in preterm infants and provide predictive of their occurrence. The rates of MMP-3, PDGF-C and PAI-1 free in cord blood, and the polymorphism of PAI-1 gene and eNOS could separately or associated with the main criterion to identify predictive of hemorrhages.
The main objective is to search a rate difference of the complex t-PA-PAI-1 in cord blood of preterm infants (before 30 weeks of gestation) that would predict intracranial hemorrhage coming in the first days of life.
The secondary objectives are
* Evaluate potential marker risk of high levels of MMP-3, PAI-1 free, and PDGF-CC
* Search in both groups the presence of alleles -675G4 / G5 and 11053 (G / T) of the PAI-1 gene and -922 (A / G) of the eNOS gene.
120 preterm infants will be included before 30 weeks of gestation with precise inclusion and exclusion criteria during a period of 3 years.
Patients will be divided into two groups according to whether they will or not showed intracranial hemorrhage (detected by ultrasound J5-J7).
The complex rate tPA-PAI-1, PAI-1 free, MMP-3 and PDGF-C will be measured. The comparison between the two groups will be carried out using statistical tests. Comparison of the presence of the alleles -675 4G and 11053T the PAI-1 gene or -922G eNOS gene between the two groups will be performed.
The demonstration of this hypothesis would permit to identify children from birth in whom the immediate implementation of preventive treatment of bleeding is desirable.
Detailed Description
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Conditions
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Study Design
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NON_RANDOMIZED
SINGLE_GROUP
PREVENTION
NONE
Study Groups
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preterm infants with intracranial hemorrhage
Cord blood analysis of preterm infants with radiological finding of intracranial hemorrhage, detected by ultrasound between day 5 and day 7 post-birth (Standard cranial echography) will be collected and analysed
Standard cranial echography
Standard cranial echography will be done at day 5 day 7 post-birth looking for radiological finding of intraventricular hemorrhage
Cord blood analysis
Cord blood will be collected during deliverance and analysed
preterm infants without intracranial hemorrhage
Cord blood analysis of preterm infants without radiological finding of intracranial hemorrhage, detected by ultrasound between day 5 and day 7 post-birth (Standard cranial echography) will be collected and analysed
Standard cranial echography
Standard cranial echography will be done at day 5 day 7 post-birth looking for radiological finding of intraventricular hemorrhage
Cord blood analysis
Cord blood will be collected during deliverance and analysed
Interventions
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Standard cranial echography
Standard cranial echography will be done at day 5 day 7 post-birth looking for radiological finding of intraventricular hemorrhage
Cord blood analysis
Cord blood will be collected during deliverance and analysed
Eligibility Criteria
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Inclusion Criteria
* Infants of both sexes
* Children whose parents signed a free and informed consent after oral information by one of the study investigators
* Exact term (pregnancy onset evaluated by the craniocaudal length or the date of the puncture in a medical assisted reproduction)
* Children with social protection
Exclusion Criteria
* Acquired maternal disease constituting a risk factor for neonatal hemorrhage
* Constitutional maternal disease constituting a risk factor for neonatal hemorrhage
* Severe fetal malformation
* Cesarean birth after diagnosis of hydrocephalus detected in utero
* Minors parents
* History of mental disease,or sensory abnormality of one of the parents, which can lead to confusion about the study
1 Day
1 Day
ALL
No
Sponsors
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University Hospital, Rouen
OTHER
Responsible Party
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Principal Investigators
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Stéphane MARRET, Pr
Role: PRINCIPAL_INVESTIGATOR
UH Rouen
Locations
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Rouen University Hospital
Rouen, , France
Countries
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Central Contacts
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Facility Contacts
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Lénaïg DONVAL, MD
Role: primary
Other Identifiers
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2014/061/HP
Identifier Type: -
Identifier Source: org_study_id