Cord Blood S100B Protein Levels in Neonates Following Intrauterine Transfusions for HDFN-Associated Fetal Anemia

NCT ID: NCT06984445

Last Updated: 2025-05-22

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

180 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-07-17

Study Completion Date

2026-04-30

Brief Summary

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levated levels of S100B protein are a well-established marker of central nervous system (CNS) damage. Fetal anemia resulting from hemolytic disease of the fetus and newborn (HDFN) often necessitates intrauterine transfusions (IUTs) and represents a significant risk factor for CNS injury. However, it remains uncertain whether S100B protein levels can reliably predict which fetuses are at higher risk for CNS complications in this context. Furthermore, the potential role of measuring S100B concentrations before IUT in prenatal assessments, and its relationship to the severity of anemia and fetal cerebral blood flow, remains poorly understood. This study aims to investigate the concentration of S100B protein in cord blood from newborns with HDFN-related fetal anemia requiring IUT. The study group comprises pregnancies complicated by HDFN with abnormal middle cerebral artery (MCA) blood flow, indicating the need for IUT. In this group, S100B protein levels will be measured before each IUT, with additional measurements if further transfusions are required. The control group consists of pregnancies with HDFN that do not require IUT. Cord blood samples will be collected at birth to evaluate S100B protein levels in both groups. Additionally, fetal MCA blood flow will be monitored, and in the study group, fetal hemoglobin and hematocrit levels will be assessed before each IUT. The primary endpoints of the study include the measurement of cord blood S100B protein levels before IUT in the study group and at birth in both groups. Secondary endpoints will explore the potential correlations between S100B protein levels and umbilical cord blood gas parameters (e.g., pH, BE, lactate), fetal cerebral blood flow parameters (e.g., MCA-PSV values), and blood count parameters (e.g., hemoglobin and hematocrit levels), both before IUT in the study group and after birth in both groups.

Detailed Description

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Conditions

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s100b Hypoxia-Ischemia, Brain Hemolytic Disease of the Fetus and Newborn Fetal Anemia

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Study group

Pregnant women with HDFN-related fetal anemia requiring intrauterine transfusion (IUT). The need for IUT is determined based on prenatal ultrasound assessment of the peak systolic velocity in the middle cerebral artery (MCA-PSV), expressed as multiples of the median (MoM). A MoM value greater than 1.5 is indicative of severe fetal anemia and serves as the primary criterion for IUT.

Cord blood S100B protein level prior to IUT

Intervention Type DIAGNOSTIC_TEST

One milliliter of cord blood will be collected before each IUT procedure to measure S100B protein concentration. The sample will be labeled with the mother's name, date of birth, collection date, and IUT indication, then sent to the laboratory for centrifugation.

Umbilical cord blood gas analysis prior to IUT

Intervention Type DIAGNOSTIC_TEST

Half a milliliter of cord blood will be collected before each IUT procedure for immediate umbilical cord blood gas analysis, including pH, base excess (BE), and lactate levels.

Fetal blood count evaluation prior to IUT

Intervention Type DIAGNOSTIC_TEST

Fetal blood count data, including hemoglobin and hematocrit levels, will be collected before each IUT procedure.

Cord blood S100B protein concentration at birth

Intervention Type DIAGNOSTIC_TEST

After delivery, one milliliter of blood will be collected from the severed umbilical cord to measure the concentration of S100B protein. The sample will be labeled with the mother's name, the child's birth date and sex, and the collection date, before being sent to the laboratory for centrifugation.

Umbilical cord blood gas analysis at birth

Intervention Type DIAGNOSTIC_TEST

After birth, 0.5 mL of blood will be collected from the severed umbilical cord to assess pH, base excess (BE), and lactate levels in an umbilical cord blood gas analysis.

Complete blood count after birth

Intervention Type DIAGNOSTIC_TEST

Complete blood count parameters, including hematocrit (Hct) and hemoglobin (Hgb) concentrations, will be measured within six hours after birth.

Ultrasound evaluation of fetal blood flow

Intervention Type DIAGNOSTIC_TEST

Fetal cerebral blood flow will be routinely assessed via ultrasound, including measurements of MCA-PSV values.

Neonatal transfontanelle ultrasound assessment

Intervention Type DIAGNOSTIC_TEST

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

Complete blood count analysis in cord blood at birth

Intervention Type DIAGNOSTIC_TEST

Complete blood count parameters, including hematocrit (Hct) and hemoglobin (Hgb) concentrations, will be measured in cord blood samples collected at birth.

Control group

Women with pregnancies complicated by HDFN who do not meet the criteria for intrauterine transfusion (IUT).

Cord blood S100B protein concentration at birth

Intervention Type DIAGNOSTIC_TEST

After delivery, one milliliter of blood will be collected from the severed umbilical cord to measure the concentration of S100B protein. The sample will be labeled with the mother's name, the child's birth date and sex, and the collection date, before being sent to the laboratory for centrifugation.

Umbilical cord blood gas analysis at birth

Intervention Type DIAGNOSTIC_TEST

After birth, 0.5 mL of blood will be collected from the severed umbilical cord to assess pH, base excess (BE), and lactate levels in an umbilical cord blood gas analysis.

Complete blood count after birth

Intervention Type DIAGNOSTIC_TEST

Complete blood count parameters, including hematocrit (Hct) and hemoglobin (Hgb) concentrations, will be measured within six hours after birth.

Ultrasound evaluation of fetal blood flow

Intervention Type DIAGNOSTIC_TEST

Fetal cerebral blood flow will be routinely assessed via ultrasound, including measurements of MCA-PSV values.

Neonatal transfontanelle ultrasound assessment

Intervention Type DIAGNOSTIC_TEST

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

Complete blood count analysis in cord blood at birth

Intervention Type DIAGNOSTIC_TEST

Complete blood count parameters, including hematocrit (Hct) and hemoglobin (Hgb) concentrations, will be measured in cord blood samples collected at birth.

Interventions

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Cord blood S100B protein level prior to IUT

One milliliter of cord blood will be collected before each IUT procedure to measure S100B protein concentration. The sample will be labeled with the mother's name, date of birth, collection date, and IUT indication, then sent to the laboratory for centrifugation.

Intervention Type DIAGNOSTIC_TEST

Umbilical cord blood gas analysis prior to IUT

Half a milliliter of cord blood will be collected before each IUT procedure for immediate umbilical cord blood gas analysis, including pH, base excess (BE), and lactate levels.

Intervention Type DIAGNOSTIC_TEST

Fetal blood count evaluation prior to IUT

Fetal blood count data, including hemoglobin and hematocrit levels, will be collected before each IUT procedure.

Intervention Type DIAGNOSTIC_TEST

Cord blood S100B protein concentration at birth

After delivery, one milliliter of blood will be collected from the severed umbilical cord to measure the concentration of S100B protein. The sample will be labeled with the mother's name, the child's birth date and sex, and the collection date, before being sent to the laboratory for centrifugation.

Intervention Type DIAGNOSTIC_TEST

Umbilical cord blood gas analysis at birth

After birth, 0.5 mL of blood will be collected from the severed umbilical cord to assess pH, base excess (BE), and lactate levels in an umbilical cord blood gas analysis.

Intervention Type DIAGNOSTIC_TEST

Complete blood count after birth

Complete blood count parameters, including hematocrit (Hct) and hemoglobin (Hgb) concentrations, will be measured within six hours after birth.

Intervention Type DIAGNOSTIC_TEST

Ultrasound evaluation of fetal blood flow

Fetal cerebral blood flow will be routinely assessed via ultrasound, including measurements of MCA-PSV values.

Intervention Type DIAGNOSTIC_TEST

Neonatal transfontanelle ultrasound assessment

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

Intervention Type DIAGNOSTIC_TEST

Complete blood count analysis in cord blood at birth

Complete blood count parameters, including hematocrit (Hct) and hemoglobin (Hgb) concentrations, will be measured in cord blood samples collected at birth.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Singleton pregnancy.
2. Diagnosis of HDFN confirmed by the detection of alloantibodies through maternal blood screening.
3. Availability of complete medical records, including routine ultrasound assessments of fetal MCA blood flow.
4. Fetal anemia requiring IUT, indicated by a MCA-PSV MoM value exceeding 1.5.


1. Singleton pregnancy.
2. Diagnosis of HDFN confirmed by the detection of alloantibodies through maternal blood screening.
3. Availability of complete medical records, including routine ultrasound assessments of fetal MCA blood flow.
4. No indications for IUT, as determined by MCA-PSV MoM values \<1.5 in routine assessments of fetal cerebral arterial flow.

Exclusion Criteria

1\. Maternal chronic use of selective serotonin reuptake inhibitors (SSRIs).


1\. Maternal chronic use of selective serotonin reuptake inhibitors (SSRIs).
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

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Other Identifiers

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S100BIUT

Identifier Type: -

Identifier Source: org_study_id

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