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Chorioamnionitis Affecting Fetus or NewbornAMNIO-BRAINNCT07610642

Amnioinfusion for Chorioamnionitis: Targeting Neonatal Brain Injury Biomarkers

A study testing Intrauterine Pressure Catheter and Standard obstetric care at discretion of delivery provider in people with Chorioamnionitis Affecting Fetus or Newborn and Amnioinfusion, run by Medical College of Wisconsin at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The AMNIO-BRAIN Trial is a research study looking at whether a simple treatment during labor can help protect a baby's brain. Some newborns develop a condition called hypoxic-ischemic encephalopathy (HIE), which happens when the brain does not get enough oxygen or blood flow. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Intrauterine Pressure Catheter and Standard obstetric care at discretion of delivery provider
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
80 participants
Where
1 siteUnited States
Study dates
15 Oct 2026to Dec 2027
Phase
Interventional
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Maternal age ≥18 years
  • Singleton gestation
  • Gestational age ≥36 weeks
  • Labor at time of enrollment
  • Clinical chorioamnionitis or intra-amniotic infection defined according to ACOG criteria, including: Maternal temperature ≥38.0°C At least one associated clinical finding, including:
  • 1. Maternal leukocytosis
Show all 10Show fewer
  • 2. Purulent cervical drainage
  • 3. Fetal tachycardia
  • Cervical dilation sufficient for intrauterine pressure catheter placement
  • Ability to provide informed consent

Who cannot join

  • Multifetal gestation
  • Known major fetal anomaly
  • Contraindication to vaginal delivery
  • Placenta previa
  • Category III fetal heart tracing requiring immediate delivery
  • Non-English-speaking

Trial locations and contacts

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

Brock E Polnaszek, MD,MPH contact

(414)-805-6600

bpolnaszek@mcw.edu

United States1 site, 1 recruiting
  • Froedtert Hospital and Medical College of Wisconsin Birth Center

    Milwaukee, Wisconsin, 53045

    Brock E Polnaszek, MD,MPH, 414-805-6600, bpolnaszek@mcw.edu

    Brock E Polnaszek, MD,MPH

    Recruiting

Other trials in United States

About this study

Official title: The AMNIO-BRAIN Trial: A Randomized Trial of Amnioinfusion for Chorioamnionitis Targeting Neonatal Brain Injury Biomarkers

The AMNIO-BRAIN Trial is a research study looking at whether a simple treatment during labor can help protect a baby's brain.

Some newborns develop a condition called hypoxic-ischemic encephalopathy (HIE), which happens when the brain does not get enough oxygen or blood flow. This can lead to serious health problems, including developmental delays and lifelong disabilities. While there is a cooling treatment after birth that can help, it starts only after delivery and may come too late to prevent the earliest stages of injury.

Read more

Research suggests that some brain injury may actually begin during labor, especially when there is an infection in the uterus called chorioamnionitis. This infection can cause inflammation and fever in the mother, which may increase stress on the baby and affect the baby's brain.

This study is testing whether a commonly used labor procedure called amnioinfusion can help. Amnioinfusion involves placing fluid similar to your biologic amniotic fluid into the uterus during labor. It is already used safely in many deliveries for other reasons. In prior research, this treatment slightly lowered the temperature inside the uterus and improved signs that the baby was no longer under stress.

In this study, 80 pregnant subjects with chorioamnionitis will be randomly assigned to receive amnioinfusion during labor or receive standard care without amnioinfusion. All patients will continue to receive normal treatment for infection.

After delivery, researchers will collect a small sample of blood from the umbilical cord. This blood will be tested for markers that can show whether the baby may have experienced stress or injury to the brain.

Read the detailed description

The AMNIO-BRAIN Trial is designed to investigate whether intrapartum amnioinfusion, administered during labor, for patients with clinical chorioamnionitis can reduce molecular biomarkers of neonatal brain injury at birth. This study builds upon pilot randomized trial data demonstrating that room-temperature amnioinfusion lowers intrauterine temperature and is associated with reductions in umbilical artery lactate, a validated marker of anaerobic metabolism and tissue injury.

Current understanding of neonatal brain injury suggests that neurologic injury evolves through several biologic phases. During the initial or "priming" phase: inflammatory signaling, oxidative stress, mitochondrial dysfunction, and excitotoxicity contribute to neuronal injury before the latent and secondary injury phases occur. Clinical chorioamnionitis and maternal intrapartum fever are strongly associated with activation of these inflammatory pathways and may significantly worsen fetal neurologic injury.

Experimental animal data and translational studies suggest that early cooling during the priming phase may attenuate downstream neuronal injury. However, currently available neuroprotective therapies are initiated only after birth. Therefore, interventions capable of modulating intrauterine temperature and inflammation during labor may represent an important opportunity for earlier neuroprotection.

This prospective, randomized, controlled trial will enroll 80 maternal-infant dyads at ≥36 weeks' gestation with clinical chorioamnionitis. Participants will be randomized to either intrapartum amnioinfusion using room-temperature lactated Ringer's solution or standard obstetric care without amnioinfusion. The primary outcome will be umbilical artery cord blood concentration of S100B. S100D is a validated astroglia-specific biomarker associated with hypoxic-ischemic encephalopathy, MRI-confirmed neonatal brain injury, and adverse long-term neurodevelopmental outcomes. Secondary analyses will evaluate additional biomarkers of neurologic injury and inflammation, including GFAP, Tau, and IL-6, in addition to neonatal and maternal clinical outcomes.

Cord blood samples will undergo advanced proteomic analysis using the NULISAseq CNS Disease Panel, an innovative platform capable of attomolar -level biomarker detection. This study seeks to establish biologic plausibility for intrapartum neuroprotection and generate critical preliminary data for future definitive trials targeting neonatal neurologic outcomes.

Being tested
Intrauterine Pressure Catheter, Standard obstetric care at discretion of delivery provider
Keywords
Amnioinfusion, Neonatal morbidity, Maternal morbidity, Umbilical cord gas, Healthcare Utilization, Neonatal hypoxic brain injury, Chorioamnionitis, Neonatal brain biomarkers
Medical subject headings
Chorioamnionitis

What participants receive

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

  • Intrauterine Pressure CatheterDevice

    Standardized room temperature amnioinfusion consisting of a 500mL bolus of (24°C) lactated ringer's infused over 30 minutes through an intrauterine pressure catheter (IUPC), followed by a continuous maintenance infusion of 125 mL/hour. Infusion continues until 1L is infused or delivery occurs.

  • Standard obstetric care at discretion of delivery providerOther

    Route obstetric care at the discretion of delivery provider.

Study groups in NCT07610642
Study groupRoleWhat they receive
Standard of CarePlacebo comparatorStandard obstetric care will be at the discretion of the delivery provider.
Receives: Other: Standard obstetric care at discretion of delivery provider
Room Temperature Lactated Ringer AmnioinfusionExperimentalStandardized room temperature amnioinfusion consisting of a 500 mL bolus of (24°C) lactated ringer's infused over 30 minutes through an intrauterine pressure catheter (IUPC), followed by a continuous maintenance infusion of 125 mL/hour. Infusion continues until 1L is infused or delivery occurs.
Receives: Device: Intrauterine Pressure Catheter

What is being measured

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

  1. S100B measured through NULISAseq CNS Disease Panel 120

    Panel 120 enables ultrasensitive, multiplexed quantification of 120+ neuro-specific and inflammatory proteins from just 10 µL (25 µL input) of umbilical cord blood. Panel 120 can detect and track key biomarkers of amyloid and tau pathologies, synaptic function, neurodegeneration, and inflammation in a single panel with unmatched precision and reproducibility. With assays specific the brain-derived Tau isoforms (pTau217, pTau181, pTau231, and tTau), the panel provides a comprehensive view of tau pathology from blood with unprecedented sensitivity and specificity, as well as S100B for brain specific brain injury.

    Measured: At delivery and/or part of routine childhood care through the first year of life.

Secondary outcomes (14)
  1. Concentration of umbilical cord gas values

    Umbilical cord gases including pH, lactate, base excess will be assessed.

    Measured: At delivery

  2. Number of participants with composite neonatal respiratory morbidity

    Composite neonatal morbidity including NICU admission, fever >38 degree Celsius, therapeutic hypothermia, hypoxic-ischemic encephalopathy, seizures, intracranial hemorrhage and grade, hyperbilirubinemia requiring phototherapy, suspected and culture proven sepsis, antibiotics, respiratory distress, supplemental oxygen, mechanical ventilation, intubation, or neonatal death

    Measured: After delivery though 6 weeks postpartum

  3. Time to defervesence

    Evaluate the time of birthing person becoming afebrile from her maximum temperature collected intrapartum following the intervention.

    Measured: At delivery/birth

  4. Feasibility metrics

    Evaluate feasibility metrics including number of patients approached, consented, randomized and followed to completion

    Measured: From consent to 1 year postpartum

  5. Scores on developmental screening

    Will predominately capture standard developmental screening including the Ages and Stages Questionnaires through 1 year of life. Additional developmental screening including Sarnat score and referral to subspecialists will be tracked as well.

    Measured: 1 year after delivery

  6. Number of participants with composite maternal morbidity

    Composite maternal morbidity consisting of amniotic fluid embolism, acute respiratory distress syndrome, pulmonary edema, intubation, PPH > 1000 milliliters including intervention such as estimated blood loss >1000 milliliters (mL) or uterotonics, tranexamic acid, blood transfusion or surgical interventions (dilation and curettage, Bakri, Jadha, laparotomy, interventional radiology), blood transfusion, hysterectomy, diffuse intravascular coagulation, endometritis, intraamniotic infection, maternal sepsis with culture, and death.

    Measured: Hospitalization through 6 weeks postpartum

  7. Number of participants in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Electronic (NICHD) Fetal Monitoring categories

    Using standard NICHD data, we will collect and analyze standard electronic fetal monitoring data after randomization including things like rates of tachysystole, categories, declarations, total deceleration area, variability, and accelerations

    Measured: During labor and delivery

  8. Decisional Self Efficacy (DSE)

    DSE measures self-confidence or belief in one's abilities in decision making, including shared-decision making for participating in trial. The 5-point scale, items are summed, divided by 11, multiplied by 25, and scores range from 0 [not at all confident] to 100 [very confident].

    Measured: At delivery/birth

  9. Labor Agentry Scale (LAS)

    The Labour Agentry Scale (LAS) is a validated, unifactorial, 29-item or 10-item instrument measuring a person's perceived control, confidence, and positive experiences during childbirth. It uses a 7-point Likert scale (1 = never to 7 = almost always) to assess personal agency, with higher scores reflecting higher levels of control.

    Measured: At delivery/birth

  10. Value of neonatal temperature

    The temperature of the baby at the time of delivery and route of collection (axillary, oral, or rectal) will be collected and reported.

    Measured: At delivery/birth

  11. Number of childhood participants with healthcare utilization

    Capturing all hospitalizations, emergency room visits, subspeciality referrals, ancillary referrals, and follow-up visits in the first year of life.

    Measured: 1 year after delivery

  12. Maternal intraamniotic infection treatment success

    Defined as resolution of fever within 16 hours of antibiotic administration and the absence of endometritis through 6 weeks postpartum.

    Measured: Delivery hospitalization until 6 weeks postpartum

  13. Number of childhood participants with healthcare utilization

    Capturing all hospitalizations, emergency room visits, subspeciality referrals, ancillary referrals, and follow-up visits in the first year of life

    Measured: 1 year after delivery

  14. Number of maternal participants with healthcare utilization

    Capturing all hospitalizations, emergency room visits, subspeciality referrals, ancillary referrals, and follow-up visits in the first year of life.

    Measured: From delivery until 1 year postpartum

Timeline

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

  1. First posted28 May 2026
  2. Study start15 Oct 2026
  3. Primary completionDec 2027 (estimated)
  4. Study completionDec 2027 (estimated)

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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07610642
Sponsor's protocol ID
PRO00059233
Acronym
AMNIO-BRAIN
Status last verified
Oct 2026
First submitted
20 May 2026
Last updated
26 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No: IPD data at this time is not a part of our consent process but may be considered on a case-by-case basis with contacting the principal investigator (e.g. a metanalysis) with de-identified data.

Publications

  • Polnaszek BE, Rossen J, Scarpaci M, Murphy LM, Whelan AR, Hamel M, Rouse DJ, Tuuli MG, Lewkowitz AK. Amnioinfusion for reducing umbilical artery lactate among fetuses at risk of neurologic injury: a pilot randomized clinical trial. Am J Obstet Gynecol MFM. 2024 Oct;6(10):101446. doi: 10.1016/j.ajogmf.2024.101446. Epub 2024 Aug 8. No abstract available.

    PubMed 39117278

Questions about this trial

What is this clinical trial studying?

A study testing Intrauterine Pressure Catheter and Standard obstetric care at discretion of delivery provider in people with Chorioamnionitis Affecting Fetus or Newborn and Amnioinfusion, run by Medical College of Wisconsin 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 10 inclusion and 6 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: looking for participants now, as of the sponsor's last update on 26 Oct 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 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. Some participants in this study may receive a placebo. 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 Brock E Polnaszek, MD,MPH ((414)-805-6600, bpolnaszek@mcw.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

S100B measured through NULISAseq CNS Disease Panel 120 (time frame: At delivery and/or part of routine childhood care through the first year of life.). 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 NCT07610642, which also lists 1 linked publication.

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 26 Oct 2026; AzTrials last refreshed its copy on 26 Oct 2026.

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