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Prematurity ComplicationsOutbornTRANSFNCT07580859

Antenatal vs Postnatal Transport Team Positioning in Extremely Preterm Outborn Infants

An observational study of Prematurity Complications and Neurodevelopment Outcome, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The extremely preterm outborn births (delivered in maternity units without on-site neonatal intensive care) are associated with lower survival and increased risk of severe neurodevelopmental impairment compared with inborn births (delivered in maternity units with on-site neonatal intensive care). Read more about this study

Who is it for?
Ages 0 days to 28 months
How many people
627 participants
Where
1 siteFrance
Study dates
Jun 2026to Sep 2030
How long will I take part?
28 Months
Phase
Observational
Are there results?
Not yet: the study is under way

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 0 days to 28 months
  • All sexes
  • No healthy volunteers
  • Child

Study population: Infants of 23+0-28+6 weeks of gestation born outside a level 3 maternity (level 1/2a/2b - without NICU) in Mainland France, and alive at the moment of arrival of the NNT.

Eligible for inclusion are infants for whom an antenatal call to the emergency medical service (SAMU) was initiated due to prematurity (imminent delivery and infant alive at the time of the call) and who:

  • Were born outside a level 3 maternity hospital (outborn birth) in mainland France
  • Have a gestational age at birth between of 23+0 - 28+6
  • Have parents who speak and understand French (required for telephone follow-up) To assess parent-related outcomes, parents will also be included in the study if their infant is eligible and if they have not objected to participation.

Infants will not be included if one or both parents are unable to speak and understand French, if at least one of the parents is opposed to inclusion, if they had lethal congenital malformations or if they were born outside hospital (accidental premature home births).

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Peter JONES, MB BChir PhD contact

06 12 34 76 82 ext. +33

peter.jones@aphp.fr

France1 site
  • SAMU de Pontoise, Hopital Novo

    Pontoise, 95300

    Guillaume POIRIE, MD, 06 30 61 08 13 ext. +33, guillaume.poirie@ght-novo.fr

Other trials in France

About this study

Official title: A Prospective French National Study of the Impact of Antenatal Versus Postnatal Positioning of a Neonatal Transport Team on Survival and Severe Neurodevelopmental Delay at Two Years in Outborn 23-28 Weeks Infants : outbornTRANSFER Study Protocol

The extremely preterm outborn births (delivered in maternity units without on-site neonatal intensive care) are associated with lower survival and increased risk of severe neurodevelopmental impairment compared with inborn births (delivered in maternity units with on-site neonatal intensive care).

This project aims to assess the effect of the neonatal transport team (NNT) antenatal versus postnatal positioning on outborn survival without major neurodevelopmental sequelae at two years of corrected age (CA). A national, multicenter, observational cohort will be established over a two-year period, including all outborn births between 23+0-28+6 weeks' gestation in mainland France for which a NNT is deployed and who are alive at the moment of arrival of the NNT. 627 infants born outborn and their families will be followed until the child reaches two years of corrected age.

Read more

Study will examine quality of neonatal resuscitation, stability during transport, neonatal morbidity, parental mental health and quality of life, medico-economic outcomes for both families and the healthcare system and regional provision of care.

If parents agree to participate after receiving appropriate information, hospital records will be used to collect maternal and neonatal characteristics as well as morbidity data. Telephone follow-up will be conducted one month after discharge and then every six months until 2 years of corrected age (CA). Neurodevelopment at 2 years of corrected age will be assessed using the ASQ-3, completed by the parents.

Through a detailed understanding of the processes of resuscitation, stabilization and transport, our goal is to reduce unnecessary deaths and disability for children and families, including long-term economic costs. The recommendations for the care of outborn preterm infants and for the optimization of NNT resources will be developed.

Read the detailed description

Numerous studies have shown that outborn preterm infants born at 23+0-28+6 weeks' gestation in maternity units without on-site neonatal intensive care unit (NICU) have higher rates of mortality and severe disability compared with inborn infants (delivered in maternity units with on-site neonatal intensive care). These differences are partly explained by variations in maternal characteristics, as well as in resuscitation and transport conditions. To date, no study has evaluated the impact of the presence of a neonatal transport team (NNT) beyond short-term transport-related complications.

The primary objective is to assess the effect of the antenatal NNT positioning, compared with postnatal NNT positioning, on survival without major neurodevelopmental sequelae at two years of corrected age (CA) in outborn preterm infants born at 23+0-28+6 weeks' gestation.

Secondary objectives will evaluate the effects on morbidity and mortality and neonatal health, medical interventions and the infant's stability during transport, healthcare utilization, as well as parents' experiences, mental health, and quality of life throughout follow-up. Cost-effectiveness and budget impact will also be examined, along with social and geographic inequalities in morbidity and mortality at two years. Barriers to and facilitators of organizing pediatric transport for outborn preterm infants will be identified in collaboration with neonatal transport teams.

The population included in the OutbornTRANSFER study are extremely preterm newborns born in mainland France in a maternity unit without on-site neonatal intensive care, and managed by one of the 32 specialized neonatal transport teams.

A national, multicenter, observational, longitudinal cohort will be established over a two-year period, including all outborn births between 23+0-28+6 weeks' gestation for which a NNT is deployed and who are alive at the moment of arrival of the NNT. Preterm outborn infants and their families will be followed until the child reaches two years of corrected age.

An economic evaluation will also be conducted, as well as a mixed-method study among medical professionals from participating NNT.

If the infant survives and is transported to a neonatal intensive care unit, the NNT investigator will inform the parents about the study and invite them to participate. If the investigator is unable to meet the parents, an information leaflet and a flyer (including a unique identification number and a QR code) will be placed in the child's health record booklet, enabling parents to access a study-specific electronic data collection application and to provide their non-opposition online.

Data on birth, initial care, transport, and timing of NNT positioning will be collected using the NNT data transportation sheet dedicated to the study, completed by the NNT study investigator.

The NNT study investigator will obtain hospitalization discharge reports, which include relevant medical history, pregnancy course, birth details, and the infant's hospital stay, with particular focus on severe conditions relevant to the cohort's outcome measures.

One month after hospital discharge, a research assistant will contact both parents to re-explain the telephone follow-up procedures, including the collection of data on parental experiences during hospitalization, parental mental health, and health-related quality of life since discharge. Subsequent telephone assessments will be conducted at 6, 12, 18, and 24 months corrected age.

A collaboration will be established with the Vulnerable Children Network (Réseau de Suivi des Enfants Vulnérables - RSEV), which organizes and performs auditory, ophthalmological, psychological, and physical assessments of premature infants, including the Ages and stages questionnaire (ASQ). One month prior to the infant's 24-month corrected age visit, the research assistant will contact the parents to present the ASQ-3 and encourage completion during the RSEV pediatric visit or directly via the study web app if they do not participate in the network follow-up. The research assistant will then collect the reports from the RSEV pediatrician for the 24-month visit.

The investigators will link the cohort data with data from national health data system (SNDS - Système National des Données de Santé) to evaluate healthcare consumptions by the mother (and subsequently the premature infant) during pregnancy and up to 24 months corrected age of the infant.

Being tested
Usual Care
Keywords
Prematurity, Outborn, Transport, Mortality, Cohort study, Neurodevelopment
Medical subject headings
Premature Birth

What participants receive

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

  • Usual CareOther

    Children will be followed using each participating center's usual practices. Parental experiences of hospitalization, parental mental health and health-related quality of life since discharge will be assessed by telephone at 6, 12, 18, and 24 months of corrected age.

Study groups in NCT07580859
Study groupRoleWhat they receive
Outborn InfantsExtremely preterm infants born at 23+0-28+6 weeks' gestation in maternity units without on-site neonatal intensive care.
Receives: Other: Usual Care

What is being measured

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

  1. Survival without major neurodevelopmental disability

    The primary outcome is a binary composite criteria based on three elements: 1) Survival ; 2) Absence of severe or moderate neuromotor or sensory disability at 2 yearsAC (defined as cerebral palsy with levels 2 to 5 of the gross motor classification system (GMFCS), blindness, or unilateral or bilateral deafness), allowing the application of the ASQ-3; 3) Absence of neurodevelopmental sequelae at 2 yearsAC assessed by the Age and Stage Questionnaire version 3 (the ASQ-3.). It is a parental questionnaire (completed by one or both parents together), based on their observations of their child's development. A developmental delay is defined as a score of < -2SD in one of the five subdomains of the questionnaire.

    Measured: at 2 years corrected gestational age

Secondary outcomes (22)
  1. Mortality

    Number of death during the first year (infant), the first 28 days (neonatal), the first week (early neonatal) and during hospital stay (in-hospital mortality)

    Measured: From inclusion (birth) up to one year of corrected age

  2. Severe neurological sequelae

    Binary composite criteria based on the absence of periventricular leukomalacia (cavities in the periventricular white matter during transfontanellar ultrasound) or stage 3 intraventricular hemorrhage (IVH) with associated ventricular dilatation or stage 4 IVH associated with hemorrhagic lesions in the adjacent parenchyma during transfontanellar ultrasound

    Measured: At the end of the initial period of hospitalisation, an average at 4 months after birth (inclusion)

  3. Severe morbidity

    Composite morbidity criteria defined by the absence of :

    • Periventricular leukomalacia
    • Stage 3-4 IVH
    • Severe bronchopulmonary dysplasia (BPD) defined as requiring oxygen or ventilatory support (non-invasive or endotracheal) at 36 weeks of theoretical gestational age
    • Severe necrotizing enterocolitis (NEC) corresponding to types 2 and 3 of the modified Bell classification
    • Severe retinopathy of prematurity (ROP) stage 3 or higher according to the international classification of ROP

    Measured: At the end of the initial period of hospitalisation, an average at 4 months after birth (inclusion)

  4. Hemodynamic, respiratory, and thermal parameters

    Average change in hemodynamic (BP, HR), respiratory (RR, SaO₂, FiO₂) and thermal (skin sensor temperature) parameters between departure from the maternity ward and arrival in intensive care.

    Measured: At birth

  5. Time from birth to arrival in intensive care

    Time from birth to arrival in intensive care and frequency of delay under 60 minutes

    Measured: At birth

  6. Prognosis

    Prognosis based on the TRIPS II score (Transport Risk index of Physiologic Stability, version II, comprising four weighted items: temperature, blood pressure, respiratory support, and response to stimuli).

    Measured: At birth

  7. Intubations

    Frequency of intubations, surfactant administration, and inotropic drugs administration

    Measured: At birth

  8. Cerebral palsy

    Frequency of cerebral palsy as reported by paediatrician at 2 years of corrected age

    Measured: 2 years of corrected age

  9. Major neurodevelopmental disability

    Frequency of the binary composite criteria combining : 1/Survival ; 2/Absence of severe or moderate neuromotor or sensory disability at 2 y.CA defined as cerebral palsy with levels 2 to 5 of the gross motor classification system (GMFCS), blindness, or unilateral or bilateral deafness)

    Measured: 2 years of corrected age

  10. Healthcare resource use

    Frequency of pediatric consultations (pediatrician or general practitioner); hospitalizations since discharge from neonatal care; emergency room visits without hospitalization; specialized consultations and additional imaging tests.

    Frequency of non-reimbursed care (psychologist, psychomotor therapist) and use of care facilities (CAMPS, specialized centers) and MDPH procedures (requests for financial assistance, priority cards, or parking permits).

    Measured: From birth to the end of follow-up (2 years corrected gestational age), specifically one month after the end of the initial period of hospitalisation, thereafter 6, 12, 18 and 24 months of corrected gestational age.

  11. Parental experience 1

    Average score of parental experience measured by a 0-10 numeric scale (10 indicating best experience).

    Measured: One month after discharge

  12. Parental experience 2

    Frequency of acute and post-traumatic stress measured by the IES-R scale with normal score <24, moderate risk between 24-32 and severe risk if≥ 33

    Measured: One month after discharge

  13. Parents' mental health 1

    EPDS score > 12 between 0-12 months of infants indicating high risk of postpartum depression

    Measured: One month after hospital discharge and at 6, 12, 18, and 24 months of corrected age

  14. Parent's mental health 2

    PHQ-9 score ≥ 10 over 12 months postpartum indicating moderate to severe depression in adults

    Measured: One month after hospital discharge and at 6, 12, 18 and 24 months of corrected age

  15. Parents' quality of life

    Quality of life measured by WHOQOL-Bref questionnaire. Average scoreof each sub scale will be used for comparisons

    Measured: One month after hospital discharge and at 6, 12, 18, and 24 months of corrected age.

  16. Cost-effectiveness 1

    Incremental cost-utility ratio in terms of cost per QALY gained (for parents)

    Measured: From the first enrollment to the end of follow-up for the last enrolled child (4 years and 4 months).

  17. Cost effectiveness 2

    Incremental cost-effectiveness ratio in terms of cost per life year gained (for infants)

    Measured: From the first enrollment to the end of follow-up for the last enrolled child (4 years and 4 months)

  18. Economic impact 1

    The economic impact assessed by estimating the costs and health gains (deaths/sequelae avoided) associated with generalising NNT antenatal positionning

    Measured: 5 years after hypothetical generalization

  19. Economic impact 2

    The economic impact assessed by estimating the health gains (deaths/sequelae avoided) associated with generalising NNT antenatal positioning

    Measured: 5 years after hypothetical generalization

  20. Social inequalities

    All outcomes (except economic outcomes) cross-analyzed with parental social factors (age, level of education, family composition, employment status, financial comfort, socio-professional category, country of birth, language spoken at home, social security and supplementary health insurance coverage) will be studied

    Measured: From inclusion up to 5 months after birth

  21. Regional inequalities

    All outcomes (except economic outcomes) cross-analyzed with parental spatial factors (department of residence, APL, distance from home to place of delivery, distance from home to level 3 maternity unit) will be studied

    Measured: From inclusion up to 5 months after birth

  22. NNT local organization

    Analysis of transcription to identify obstacles and drivers in the local organization of care for premature infants. Description of the characteristics of the professionals participating in the qualitative study and of each participating NNT

    Measured: From the first enrollment to the end of follow-up for the last enrolled child (4 years and 4 months).

Timeline

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

  1. First posted12 May 2026
  2. Study startJun 2026 (estimated)
  3. Primary completionSep 2030 (estimated)
  4. Study completionSep 2030 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
627 participants (estimated)
Target duration
28 Months
IDs, dates and publications
ClinicalTrials.gov ID
NCT07580859
Sponsor's protocol ID
APHP251257
Other IDs
PREPS-24-0182, 2025-A02162-47
Acronym
OutbornTRANSF
Status last verified
Apr 2026
First submitted
14 Apr 2026
Last updated
28 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Prematurity Complications and Neurodevelopment Outcome, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

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

Who may be eligible to take part?

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: opening soon, as of the sponsor's last update on 28 May 2026. 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 France. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Peter JONES, MB BChir PhD (06 12 34 76 82 ext. +33, peter.jones@aphp.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Survival without major neurodevelopmental disability (time frame: at 2 years corrected gestational age). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 28 May 2026.

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