Breath Metabolomics in the Laboring Parturient

NCT ID: NCT04564196

Last Updated: 2023-06-08

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

TERMINATED

Total Enrollment

53 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-11-11

Study Completion Date

2023-06-06

Brief Summary

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This is primarily a feasibility study to determine whether quantitative measurement of volatile organic compounds (VOCs) in the breath of parturients undergoing labor is possible.

Aim A: To determine baseline values of breath metabolites and volatile organic compounds (VOCs) in the breath for term pregnant women.

Aim B: To gather preliminary data to determine breath metabolite and volatile organic compound (VOCs) signature change during labor and delivery.

Aim C: Compare the breath metabolite and volatile organic compound (VOCs) signature women undergoing induction compared to spontaneous vaginal deliveries.

Detailed Description

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Breath metabolites, also known as volatile organic compounds (VOC's) are produced during periods of increased stress and as a marker of underlying medical conditions. The goal of this project is to collect VOCs within the breath in the initial stages of delivery in otherwise healthy parturients undergoing induction of labor. In addition to a panel of metabolites, we will obtain information on the 3400 compounds which compose the breath metabolome by gas mass spectrometry technology. This is the first step of a larger planned project to develop specialized panels of breath signatures during labor and delivery in parturients.

We will collect breath samples at bedside and measure metabolites in the laboratory. This is a feasibility study which we will use to determine normal values for a term parturient and changes of VOCs during the course of labor. We will also use this data to construct a power analysis and perform a follow-up study to test whether VOCs are associated with different aspects of pregnancy.

Conditions

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Labor Onset and Length Abnormalities

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Induction of Labor

Samples collected from women who present for induction of labor.

\- The parturient will be asked to breathe 2 tidal volume breaths into a single breath collection bag. The breath collection bag will be closed between each breath. The combined 2 tidal volume breaths will count as a single sample.

Samples will be collected at the following time points for patients presenting for induction of labor:

A) Baseline: At presentation to labor and delivery unit and prior to initiation of augmentation of labor. A total of 1 sample.

B) End of 1st stage of labor: At complete cervix dilatation and prior to starting to push. A total of 1 sample will be taken.

C) End of 3rd stage of labor: Immediately (within 30 minutes) of delivery of the neonate. A total of 1 sample will be taken.

Breath Sample

Intervention Type PROCEDURE

breathe 2 tidal volume breaths into a single breath collection bag. The breath collection bag will be closed between each breath. The combined 2 tidal volume breaths will count as a single sample.

Spontaneous Labor

Samples will be collected from women who present in spontaneous labor

\- The parturient will be asked to breathe 2 tidal volume breaths into a single breath collection bag. The breath collection bag will be closed between each breath. The combined 2 tidal volume breaths will count as a single sample.

Samples will be taken at the following endpoints:

A) End of 1st stage of labor: At completely cervix dilated and prior starting pushing. A total of 1 sample will be taken.

B) End of 3rd stage of labor: Immediately (within 30 minutes) of delivery of the neonate. A total of 1 sample will be taken.

Breath Sample

Intervention Type PROCEDURE

breathe 2 tidal volume breaths into a single breath collection bag. The breath collection bag will be closed between each breath. The combined 2 tidal volume breaths will count as a single sample.

Interventions

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Breath Sample

breathe 2 tidal volume breaths into a single breath collection bag. The breath collection bag will be closed between each breath. The combined 2 tidal volume breaths will count as a single sample.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Otherwise healthy nulliparous women with singleton term (37-41 weeks) pregnant at least 18 years of age.
* Presenting for labor (induction of labor and spontaneous labor) at LPHC.

Exclusion Criteria

* Participants unable to or refuse to give informed consent
* Participants that do not understand English or are hearing impaired
* Medical History: Chronic disease (HTN, diabetes, asthma)
* Obstetric History during this pregnancy: gestational diabetes, gestational hypertension, pre-eclampsia, Eclampsia
* Multiple gestation
* Any significant fetal anomalies
* Morbid obesity (BMI\>50)
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Stanford University

OTHER

Sponsor Role lead

Responsible Party

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Cedar J. Fowler, M.D. / Ph.D / MPH

Clinical Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Cedar J Fowler, MD/PhD/MPH

Role: PRINCIPAL_INVESTIGATOR

Stanford University

Pervez Sultan, MD

Role: PRINCIPAL_INVESTIGATOR

Stanford University

Locations

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Lucile Packard Children Hospital

Stanford, California, United States

Site Status

Countries

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United States

References

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Rattray NJ, Hamrang Z, Trivedi DK, Goodacre R, Fowler SJ. Taking your breath away: metabolomics breathes life in to personalized medicine. Trends Biotechnol. 2014 Oct;32(10):538-48. doi: 10.1016/j.tibtech.2014.08.003. Epub 2014 Aug 29.

Reference Type BACKGROUND
PMID: 25179940 (View on PubMed)

Norwitz ER, Bonney EA, Snegovskikh VV, Williams MA, Phillippe M, Park JS, Abrahams VM. Molecular Regulation of Parturition: The Role of the Decidual Clock. Cold Spring Harb Perspect Med. 2015 Apr 27;5(11):a023143. doi: 10.1101/cshperspect.a023143.

Reference Type BACKGROUND
PMID: 25918180 (View on PubMed)

McLoughlin G. Interventions during pregnancy to prevent preterm birth: An overview of Cochrane systematic reviews. Res Nurs Health. 2020 Apr;43(2):206-207. doi: 10.1002/nur.22005. Epub 2019 Dec 20. No abstract available.

Reference Type BACKGROUND
PMID: 31859369 (View on PubMed)

Wallace MAG, Pleil JD. Evolution of clinical and environmental health applications of exhaled breath research: Review of methods and instrumentation for gas-phase, condensate, and aerosols. Anal Chim Acta. 2018 Sep 18;1024:18-38. doi: 10.1016/j.aca.2018.01.069. Epub 2018 Feb 9.

Reference Type BACKGROUND
PMID: 29776545 (View on PubMed)

Sukul P, Schubert JK, Trefz P, Miekisch W. Natural menstrual rhythm and oral contraception diversely affect exhaled breath compositions. Sci Rep. 2018 Jul 18;8(1):10838. doi: 10.1038/s41598-018-29221-z.

Reference Type BACKGROUND
PMID: 30022081 (View on PubMed)

Nakhleh MK, Haick H, Humbert M, Cohen-Kaminsky S. Volatolomics of breath as an emerging frontier in pulmonary arterial hypertension. Eur Respir J. 2017 Feb 23;49(2):1601897. doi: 10.1183/13993003.01897-2016. Print 2017 Feb.

Reference Type BACKGROUND
PMID: 28232412 (View on PubMed)

Cristescu SM, Kiss R, Hekkert St, Dalby M, Harren FJ, Risby TH, Marczin N; Harefield BIOSTRESS study investigators. Real-time monitoring of endogenous lipid peroxidation by exhaled ethylene in patients undergoing cardiac surgery. Am J Physiol Lung Cell Mol Physiol. 2014 Oct 1;307(7):L509-15. doi: 10.1152/ajplung.00168.2014. Epub 2014 Aug 15.

Reference Type BACKGROUND
PMID: 25128523 (View on PubMed)

Hengelage J, Fowler C, Goldsberry MD, Stockert E, Bekemeyer Z, Lee H, Wagner NM, Sultan P, Carvalho B, Gross ER. Quantification of breath metabolites in labouring versus non-labouring patients: a feasibility study. Br J Anaesth. 2025 Sep 9:S0007-0912(25)00539-2. doi: 10.1016/j.bja.2025.07.081. Online ahead of print.

Reference Type DERIVED
PMID: 40930875 (View on PubMed)

Other Identifiers

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54731

Identifier Type: -

Identifier Source: org_study_id

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