Evaluating the Long-term Neurocognitive Effects of Preconceptional Exposure to Iodinated Contrast on the Offspring

NCT ID: NCT05168228

Last Updated: 2022-01-27

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

64 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-01-26

Study Completion Date

2022-08-01

Brief Summary

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Iodinated contrast is commonly used in hysterosalpingography (HSG), a diagnostic tool in fertility work-up. This study aims to investigate the safety of contrast media used during HSG by evaluating the long-term effects on the neurodevelopment of offspring 6-8 years after exposure to iodinated contrast media.

Detailed Description

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Background: Iodinated contrast is commonly used in hysterosalpingography (HSG), a diagnostic tool in fertility work-up. Yet excessive iodine may pool for a long time in the body, crosses the placenta easily, and can induce hypothyroidism in both mothers and foetuses. Inadequate supplies of thyroid hormones have previously been associated with neurocognitive impairments in offspring. Considering the widespread use of iodinated contrast during fertility work-up, the potential iatrogenic effect of preconceptional iodine exposure on the brain development of the offspring needs to be addressed urgently.

Objectives: This project aims to investigate the safety of contrast media used during HSG by evaluating the long-term effects on the neurodevelopment of offspring 6-8 years after exposure to iodinated contrast media. To do this, the investigators will follow up on a cohort of offspring conceived during the H2Oil randomised controlled trial (NTR 3270), which was set up to evaluate the effect of using water- or oil-based media during HSG on pregnancy rates.

Methods: The study team have previously obtained parental permission for follow-up research in 140 children conceived during the H2Oil study \<6 months after exposure to iodine during the HSG. The investigators will conduct comprehensive an in-depth outcome assessment of intelligence, neurocognitive development, school performance, and behavioural functioning.

Relevance: Using this diverse range of methods, the investigators expect to be the first to shed light on the long-term iatrogenic consequences of using iodinated contrast just before conception on the neurodevelopment of their offspring. The findings of this study will have implications for current clinical practice, where HSG is readily used in subfertile women, and will be used to inform the Dutch guidelines for fertility work-up.

Conditions

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Neurocognitive Disorders

Study Design

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Observational Model Type

COHORT

Study Time Perspective

OTHER

Interventions

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Oil- versus waterbased contrast in hysterosalpingography (HSG)

The Neuro-H2Oil study looks at the offspring of the H2Oil study, a randomized controlled trial (RCT) comparing hysterosalpingography (HSG) with oil- versus water-based contrast during fertility work-up. For more information please see NTR 3270 (original H2Oil study), www.trialregister.nl. The control group is the Database for Controls in Neuroscience Studies (D-CNS), registered as NL9574 (https://www.trialregister.nl/trial/9574).

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Children conceived after the mother underwent HSG procedure in the context of the H2Oil trial (2012-2014)
* Children must be conceived \<6 months after the HSG procedure
* Parents must have given consent for recontacting for follow up research

Exclusion Criteria

* Children conceived after the mother underwent HSG procedure that was not part of the H2Oil trial
* Children conceived \>6 months after the HSG procedure
* Children whose parents did not give permission to be recontacted for follow up research
* Children that are not able to comprehend the instructions at the time of assessment
* Absence or withdrawal of written informed consent
* Inability to comprehend testing instructions at time of assessment
* Severe motor disability that interferes with outcome assessment at time of assessment
* Documented and/or parent-reported diagnosis of a neurological disorder
* Somatic disorders known to affect the outcome assessments at time of assessment
Minimum Eligible Age

5 Years

Maximum Eligible Age

10 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

OTHER

Sponsor Role collaborator

Amsterdam UMC, location VUmc

OTHER

Sponsor Role lead

Responsible Party

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Prof. Velja Mijatovic

Professor in Obstetrics and Gynaecology, Specialist in Reproductive Medicine, Head of Endometriosis Center VUmc

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marsh Königs, PhD

Role: PRINCIPAL_INVESTIGATOR

Emma Children's Hospital, Amsterdam UMC

Locations

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Emma Kinderziekenhuis

Amsterdam, North Holland, Netherlands

Site Status

Countries

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Netherlands

References

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Konigs M, Verhoog EM, Oosterlaan J. Exploring the neurocognome: Neurocognitive network organization in healthy young adults. Cortex. 2021 Oct;143:12-28. doi: 10.1016/j.cortex.2021.06.011. Epub 2021 Jul 14.

Reference Type BACKGROUND
PMID: 34365200 (View on PubMed)

Dreyer K, van Rijswijk J, Mijatovic V, Goddijn M, Verhoeve HR, van Rooij IAJ, Hoek A, Bourdrez P, Nap AW, Rijnsaardt-Lukassen HGM, Timmerman CCM, Kaplan M, Hooker AB, Gijsen AP, van Golde R, van Heteren CF, Sluijmer AV, de Bruin JP, Smeenk JMJ, de Boer JAM, Scheenjes E, Duijn AEJ, Mozes A, Pelinck MJ, Traas MAF, van Hooff MHA, van Unnik GA, de Koning CH, van Geloven N, Twisk JWR, Hompes PGA, Mol BWJ. Oil-Based or Water-Based Contrast for Hysterosalpingography in Infertile Women. N Engl J Med. 2017 May 25;376(21):2043-2052. doi: 10.1056/NEJMoa1612337. Epub 2017 May 18.

Reference Type BACKGROUND
PMID: 28520519 (View on PubMed)

Keestra SM, Van Welie N, Dreyer K, Van Eekelen R, Roseboom TJ, Oosterlaan J, Mol BW, Finken MJJ, Mijatovic V, Konigs M. Neurodevelopmental outcomes of school-age children conceived after hysterosalpingography with oil-based or water-based iodinated contrast: long-term follow-up of a nationwide randomized controlled trial. Hum Reprod. 2024 Oct 1;39(10):2287-2296. doi: 10.1093/humrep/deae183.

Reference Type DERIVED
PMID: 39198011 (View on PubMed)

Other Identifiers

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2021.0448

Identifier Type: -

Identifier Source: org_study_id

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