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Preterm InfantNCT03694613

Utility of Placental/Umbilical Cord Blood in Early Onset Neonatal Sepsis in Very Low Birth Weight Infants

A study testing Placental/Umbilical Cord Blood sample in people with Preterm Infant and Early-Onset Neonatal Sepsis, run by The University of Texas Medical Branch, Galveston at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study evaluates the utility of placental/umbilical cord blood (PUCB) to perform the baseline workup testing for EONS in Very Low Birth Weight Infants: CBC (Complete Blood Count) with differential, Immature/Total ratio (I/T ratio), and blood culture along with CRP and IL-6 levels. Read more about this study

Who is it for?
Ages Up to 1 day
What is being tested?
Placental/Umbilical Cord Blood sample
Could I receive a placebo?
No, everyone receives an active treatment
How many people
65 participants
Where
1 siteUnited States
Study dates
1 Jun 2019to 20 Aug 2020
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Up to 1 day
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Infants <34 weeks' gestational

Who cannot join

  • Known congenital or chromosomal anomalies
  • Congenital heart disease (other than Patent Ductus Arteriosus, Patent Foramen Ovale or Atrial Septum Defect)
  • Vaginal bleeding at admission

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Sergio Mauricio Lerma Narvaez

    Galveston, Texas, 77550

Other trials in United States

About this study

Official title: A Pilot Study to Evaluate the Utility of Placental/Umbilical Cord Blood (PUCB) in Early Onset Neonatal Sepsis (EONS) in Very Low Birth Weight Infants

This study evaluates the utility of placental/umbilical cord blood (PUCB) to perform the baseline workup testing for EONS in Very Low Birth Weight Infants: CBC (Complete Blood Count) with differential, Immature/Total ratio (I/T ratio), and blood culture along with CRP and IL-6 levels. A cohort (63 subjects) of preterm infants will be recruited. All the participants will be evaluated for sepsis using placental/umbilical cord blood (PUCB) and subject blood sample during the first 12 hours of life (after birth).

Read the detailed description

Early Onset Neonatal Sepsis (EONS) is common in preterm infants, and it is associated with high morbidity and mortality, especially if not diagnosed early. Currently the baseline workup is done using blood samples from the infant to perform Blood culture, CBC, I/T ratio. These tests have shown to have low sensitivity and specificity to diagnosis EONS.

PUCB can be another safe source of blood which is useful, painless and simple to collect. As CBC, I/T ratio and blood culture may not be enough to diagnose EONS we will add IL-6 and CRP which will increase sensitivity and specificity to diagnose EONS in preterm infants without collecting blood from the infants.

This study may be a step to decrease iatrogenic blood loss to diagnose EONS. The primary outcome of the current research will be to find out the utility of PUCB in diagnosing EOS in preterm infants (<30 weeks and <1250 grams birth weight). Using PUCB can increase the accuracy to diagnose Sepsis in Preterm infants, and it will also conserve blood in the extremely premature infants while reducing hemodynamic instability due to acute blood loss.

Being tested
Placental/Umbilical Cord Blood sample
Keywords
Preterm Infant, Early-Onset Neonatal Sepsis, Umbilical Cord, Complete Cell Count, Placenta, Blood Culture
Medical subject headings
Premature Birth, Neonatal Sepsis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Placental/Umbilical Cord Blood sampleOther

    After infant is delivered, placenta along with clamped umbilical cord Blood will be obtained from the ObGyn team. One umbilical clamp will be placed at the umbilical end, and the other clamp will be placed on the placental end of the umbilical cord. Then the umbilical cord will be cut between the clamps. The umbilical cord will be cleaned three times with 2% chlorhexidine, plus 70% isopropyl alcohol under sterile conditions (sterile gloves). Cord blood samples will be collected using vacutainer blood collecting system with a sterile 22-gauge needle. We will collect 3 - 4 ml of blood.

Study groups in NCT03694613
Study groupRoleWhat they receive
Placental/Umbilical Cord Blood sampleOtherPlacental/Umbilical Cord Blood sample will be collected after delivery from every participant.
Receives: Other: Placental/Umbilical Cord Blood sample

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. White Blood Cell Count (WBC) (1)

    Normal Range approximately 6,000 - 30,000 cell/mm3.

    Measured: Completed during the first 30 minutes after birth. This sample is going to be taken from the discarded Placental/umbilical blood cord.

  2. White Blood Cell Count (WBC) (1) INFANT BLOOD

    Normal Range: 6.000 - 30.000 cell/mm3.

    Measured: Completed during the first 6 hours after birth. This sample is going to be taken directly from the participant.

  3. I/T Ratio (Immature/Total Immature Neutrophil).I/T Ratio Was Calculated by Dividing Immature White Cell Count Total White Cell Count

    Normal Range of I/T ratio: <0.2.

    Measured: Completed during the first 30 minutes after birth. This sample is going to be taken from the discarded Placental/umbilical blood cord.

  4. I/T Ratio (Immature/Total Immature Neutrophil Ratio) INFANT BLOOD

    Normal Range: <0.2

    Measured: Completed during the first 12 hours after birth. This sample is going to be taken directly from the participant.

  5. CRP (C-Reactive Protein)(1)

    Normal Range: < 10,000 ng/mL

    Measured: Completed during the first 30 minutes after birth. This sample is going to be taken from the discarded Placental/umbilical blood cord.

  6. CRP (C-Reactive Protein)(2) INFANT BLOOD

    Normal Range: <10.000ng/mL

    Measured: Completed during the first 6 hours after birth. This sample was taken directly from the participant.

  7. IL-6 (1)

    Normal Range: 0-10.2 pg/ml

    Measured: Completed during the first 30 minutes after birth. This sample is going to be taken from the discarded Placental/umbilical blood cord.

  8. IL-6 (Interleukin-6) INFANTS BLOOD

    Normal Range: <100 pg/mL

    Measured: Completed during the first 6hours after birth. This sample is going to be taken directly from the participant.

  9. Procalcitonin PUBC

    Blood was taken from PUBC after delivery

    Measured: Within 30 minutes after delivery

  10. Procalcitonin Level Was Measured in the Blood From Placenta and From the Baby Within 6 Hours After Birth

    Procalcitonin levels

    Measured: Procalcitonin Level was measured in the blood from placenta and in Infant's Blood (within 6 hours)

  11. Number of Participants With Negative Blood Culture From Blood Drawn From Placenta and From Baby Within 6 Hours After Birth

    Normal Range: Blood Culture Negative

    Measured: Blood sample drawn from placenta and from baby within 6 hours after birth.

  12. Presepsin- PUBC

    Presepsin level was measured in the blood drawn from placenta and from the baby within 6 hours after birth

    Measured: First 30 min after birth

  13. Presepsin-Infant's Blood

    Levels of presepsin

    Measured: First 30 min after birth

  14. Number of Participants With a Negative Blood Culture

    Blood is taken from infants after birth

    Measured: first 2 hours after birth

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Oct 2018
  2. Study start1 Jun 2019
  3. Primary completion1 Jun 2020
  4. Study completion20 Aug 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
65 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03694613
Sponsor's protocol ID
18-0165
Status last verified
Nov 2020
First submitted
28 Sep 2018
Last updated
10 Aug 2021
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Qazi SA, Stoll BJ. Neonatal sepsis: a major global public health challenge. Pediatr Infect Dis J. 2009 Jan;28(1 Suppl):S1-2. doi: 10.1097/INF.0b013e31819587a9. No abstract available.

    PubMed 19106756
  • Brown DR, Kutler D, Rai B, Chan T, Cohen M. Bacterial concentration and blood volume required for a positive blood culture. J Perinatol. 1995 Mar-Apr;15(2):157-9.

    PubMed 7595778
  • Hornik CP, Benjamin DK, Becker KC, Benjamin DK Jr, Li J, Clark RH, Cohen-Wolkowiez M, Smith PB. Use of the complete blood cell count in early-onset neonatal sepsis. Pediatr Infect Dis J. 2012 Aug;31(8):799-802. doi: 10.1097/INF.0b013e318256905c.

    PubMed 22531231
  • Malik A, Hui CP, Pennie RA, Kirpalani H. Beyond the complete blood cell count and C-reactive protein: a systematic review of modern diagnostic tests for neonatal sepsis. Arch Pediatr Adolesc Med. 2003 Jun;157(6):511-6. doi: 10.1001/archpedi.157.6.511.

    PubMed 12796229
  • Ng PC. Diagnostic markers of infection in neonates. Arch Dis Child Fetal Neonatal Ed. 2004 May;89(3):F229-35. doi: 10.1136/adc.2002.023838.

    PubMed 15102726
  • Laborada G, Rego M, Jain A, Guliano M, Stavola J, Ballabh P, Krauss AN, Auld PA, Nesin M. Diagnostic value of cytokines and C-reactive protein in the first 24 hours of neonatal sepsis. Am J Perinatol. 2003 Nov;20(8):491-501. doi: 10.1055/s-2003-45382.

    PubMed 14703598
  • Christensen RD, Lambert DK, Baer VL, Montgomery DP, Barney CK, Coulter DM, Ilstrup S, Bennett ST. Postponing or eliminating red blood cell transfusions of very low birth weight neonates by obtaining all baseline laboratory blood tests from otherwise discarded fetal blood in the placenta. Transfusion. 2011 Feb;51(2):253-8. doi: 10.1111/j.1537-2995.2010.02827.x. Epub 2010 Aug 16.

    PubMed 20723166
  • Meena J, Charles MV, Ali A, Ramakrishnan S, Gosh S, Seetha KS. Utility of cord blood culture in early onset neonatal sepsis. Australas Med J. 2015 Aug 31;8(8):263-7. doi: 10.4066/AMJ.2015.2460. eCollection 2015.

    PubMed 26392823
  • Beeram MR, Loughran C, Cipriani C, Govande V. Utilization of umbilical cord blood for the evaluation of group B streptococcal sepsis screening. Clin Pediatr (Phila). 2012 May;51(5):447-53. doi: 10.1177/0009922811431882. Epub 2011 Dec 22.

    PubMed 22199177
  • Joram N, Boscher C, Denizot S, Loubersac V, Winer N, Roze JC, Gras-Le Guen C. Umbilical cord blood procalcitonin and C reactive protein concentrations as markers for early diagnosis of very early onset neonatal infection. Arch Dis Child Fetal Neonatal Ed. 2006 Jan;91(1):F65-6. doi: 10.1136/adc.2005.074245.

    PubMed 16371391
  • Baer VL, Lambert DK, Carroll PD, Gerday E, Christensen RD. Using umbilical cord blood for the initial blood tests of VLBW neonates results in higher hemoglobin and fewer RBC transfusions. J Perinatol. 2013 May;33(5):363-5. doi: 10.1038/jp.2012.127. Epub 2012 Oct 4.

    PubMed 23047426

Questions about this trial

What is this clinical trial studying?

A study testing Placental/Umbilical Cord Blood sample in people with Preterm Infant and Early-Onset Neonatal Sepsis, run by The University of Texas Medical Branch, Galveston at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 Aug 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 10 Aug 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

White Blood Cell Count (WBC) (1) (time frame: Completed during the first 30 minutes after birth. This sample is going to be taken from the discarded Placental/umbilical blood cord.). The study lists 14 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03694613, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Aug 2021.

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