Cord Blood S100B Protein Concentration in Neonates With Fetal Growth Restriction

NCT ID: NCT06893926

Last Updated: 2025-03-25

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

RECRUITING

Total Enrollment

120 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-06-18

Study Completion Date

2026-03-31

Brief Summary

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S100B protein is a biomarker that increases following central nervous system (CNS) damage. Measuring this protein's levels may allow for the early identification of infants at high risk for developmental abnormalities, such as fetal growth restriction (FGR), even on the first day of life, in a non-invasive manner. Early detection could enable timely interventions and rehabilitation, potentially improving the child's prognosis and long-term outcomes. This study investigates two groups of full-term pregnancies: a study group with prenatally diagnosed late FGR, and a control group with normal fetal growth. Following delivery, cord blood samples from both groups will be analyzed for S100B protein concentrations, pH, base excess (BE), and lactate levels. Additionally, fetal blood flow parameters in the umbilical artery (UA), uterine arteries (UtA), ductus venosus (DV), and middle cerebral artery (MCA) will be monitored via ultrasound within 48 hours before delivery. This study aims to compare S100B protein concentrations in umbilical cord blood between the two groups and to assess correlations with fetal Doppler parameters, pH, BE, and lactate levels in cord blood gas analysis. Ultimately, we seek to determine the effectiveness of S100B protein concentration as a biomarker for diagnosing fetal CNS hypoxia- ischemia in FGR-affected children, compared to those with normal growth.

Detailed Description

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Conditions

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s100b Hypoxia-Ischemia, Brain Fetal Growth Restriction (FGR)

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Study group

Women with a full-term pregnancy and a prenatal diagnosis of late-onset FGR.

Prenatal ultrasound examination with blood flow analysis

Intervention Type DIAGNOSTIC_TEST

For all patients who provide informed consent to participate in the study, an ultrasound examination is performed within 48 hours prior to delivery. This assessment includes:

1. Measurement of fetal anthropometric parameters and estimation of fetal weight.
2. Evaluation of blood flow using the pulsatility index (PI) in the UA, UtA, DV, and MCA.

Umbilical cord blood gas analysis

Intervention Type DIAGNOSTIC_TEST

A 0.5 mL blood sample is collected from the clamped section of the umbilical cord and immediately sent to the laboratory for cord blood gas analysis, including the determination of pH, base excess (BE), and lactate levels.

Umbilical cord blood S100B protein level

Intervention Type DIAGNOSTIC_TEST

A 1 mL sample of cord blood is collected in a labeled tube, which includes the mother's name, the child's gender, date of birth, and date of collection. The sample is then sent to the laboratory for centrifugation. The resulting serum samples are frozen, and once approximately 80 samples have been collected, they will be thawed and analyzed for S100B protein concentration. Any remaining material after laboratory processing will be properly disposed of.

Neonatal transfontanelle ultrasound assessment

Intervention Type DIAGNOSTIC_TEST

A transfontanelle ultrasound examination is performed to assess for any abnormalities in the newborn.

Control group

Women with a full-term pregnancy and normal fetal development.

Prenatal ultrasound examination with blood flow analysis

Intervention Type DIAGNOSTIC_TEST

For all patients who provide informed consent to participate in the study, an ultrasound examination is performed within 48 hours prior to delivery. This assessment includes:

1. Measurement of fetal anthropometric parameters and estimation of fetal weight.
2. Evaluation of blood flow using the pulsatility index (PI) in the UA, UtA, DV, and MCA.

Umbilical cord blood gas analysis

Intervention Type DIAGNOSTIC_TEST

A 0.5 mL blood sample is collected from the clamped section of the umbilical cord and immediately sent to the laboratory for cord blood gas analysis, including the determination of pH, base excess (BE), and lactate levels.

Umbilical cord blood S100B protein level

Intervention Type DIAGNOSTIC_TEST

A 1 mL sample of cord blood is collected in a labeled tube, which includes the mother's name, the child's gender, date of birth, and date of collection. The sample is then sent to the laboratory for centrifugation. The resulting serum samples are frozen, and once approximately 80 samples have been collected, they will be thawed and analyzed for S100B protein concentration. Any remaining material after laboratory processing will be properly disposed of.

Neonatal transfontanelle ultrasound assessment

Intervention Type DIAGNOSTIC_TEST

A transfontanelle ultrasound examination is performed to assess for any abnormalities in the newborn.

Interventions

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Prenatal ultrasound examination with blood flow analysis

For all patients who provide informed consent to participate in the study, an ultrasound examination is performed within 48 hours prior to delivery. This assessment includes:

1. Measurement of fetal anthropometric parameters and estimation of fetal weight.
2. Evaluation of blood flow using the pulsatility index (PI) in the UA, UtA, DV, and MCA.

Intervention Type DIAGNOSTIC_TEST

Umbilical cord blood gas analysis

A 0.5 mL blood sample is collected from the clamped section of the umbilical cord and immediately sent to the laboratory for cord blood gas analysis, including the determination of pH, base excess (BE), and lactate levels.

Intervention Type DIAGNOSTIC_TEST

Umbilical cord blood S100B protein level

A 1 mL sample of cord blood is collected in a labeled tube, which includes the mother's name, the child's gender, date of birth, and date of collection. The sample is then sent to the laboratory for centrifugation. The resulting serum samples are frozen, and once approximately 80 samples have been collected, they will be thawed and analyzed for S100B protein concentration. Any remaining material after laboratory processing will be properly disposed of.

Intervention Type DIAGNOSTIC_TEST

Neonatal transfontanelle ultrasound assessment

A transfontanelle ultrasound examination is performed to assess for any abnormalities in the newborn.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Women with a full-term pregnancy (≥37 weeks of gestation), singleton.
2. Pregnancy complicated by FGR.


1. Women with a full-term pregnancy (≥37 weeks of gestation), singleton.
2. Pregnancy not complicated by FGR.

Exclusion Criteria

1. Antenatal (at recruitment):

* Maternal conditions that may affect the blood flow in placental vessels, including smoking, use of illicit stimulant substances, or pregestational diabetes.
* Maternal depression requiring pharmacological treatment (e.g., SSRIs).
2. Intrapartum:

* Factors indicating a possible intrauterine infection, such as amniotic fluid leakage for more than 15 hours, spontaneous preterm labor, diagnosed intrauterine infection, or symptoms of infection in the mother.
* Prolonged labor lasting more than 15 hours.


1. Antenatal (at recruitment):

* Maternal conditions that may affect placental blood flow, such as smoking, use of illicit stimulant substances, pregestational diabetes, or chronic hypertension.
* Maternal depression requiring pharmacological treatment (e.g., SSRIs).
* Risk factors for intrauterine HI, including abnormal fetal blood flow parameters on ultrasound, abnormal CTG recordings, or the need for intrauterine transfusion.
2. Intrapartum:

* Indicators of possible intrauterine infection, such as amniotic fluid leakage for more than 15 hours, spontaneous preterm delivery, diagnosed intrauterine infection, or maternal symptoms of infection.
* Risk factors for perinatal HI.
* Prolonged labor lasting more than 15 hours (counted from the onset of regular uterine contractions).
* Birth weight below the 10th percentile or above the 90th percentile.
* Apgar score less than 8 at the 1st, 3rd, 5th, or 10th minute of life.
* Abnormal umbilical cord blood gas analysis results, defined as pH \< 7.15 or BE \< -9.3 mmol/l.
3. Postnatal:

* Neonatal anemia requiring a top-up transfusion within the first 24 hours of life
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Institute of Mother and Child, Warsaw, Poland

OTHER

Sponsor Role lead

Responsible Party

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Agnieszka Drozdowska-Szymczak

MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Agnieszka A. Drozdowska-Szymczak, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Institute of Mother and Child in Warsaw, Poland

Locations

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Institute of Mother and Child

Warsaw, , Poland

Site Status RECRUITING

Countries

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Poland

Central Contacts

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Agnieszka A. Drozdowska-Szymczak, MD, PhD

Role: CONTACT

+48 22 32 77 411

Sabina A. Łukawska, MD

Role: CONTACT

+48 691 235 077

Facility Contacts

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Agnieszka A. Drozdowska-Szymczak, MD, PhD

Role: primary

+48 22 32 77 411

Sabina A. Łukawska, MD

Role: backup

+48 691 235 077

References

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Other Identifiers

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S100BFGR

Identifier Type: -

Identifier Source: org_study_id

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