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CompletedNCT03433846Updated May 20, 2022

Predictors of Sepsis in Ex-Preterm Infants

An observational study in Sepsis and Premature Birth, sponsored by Boston Children's Hospital. Completed at 1 site in United States. Open to participants aged 0 Days to 2 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2022-05-20.

Sponsored by Boston Children's Hospital · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
40
Ages
0 Days to 2 Years
Sex
All
01

Study summary

The aims of this study are to:

  • Assess whether ex-preterm infants have a persistently immature immune system, which may decrease their ability to respond to infections, when they reach term-corrected gestational age.
  • Examine whether clinical history, nutrition status, and microbiome composition are linked to the immune composition of term and ex-preterm infants and whether these variables can be used to predict the risk of developing sepsis or having an immunologic disease.
Read the detailed description

Preterm infants have increased numbers of viral infections in childhood. They are also more likely to die from infection during the neonatal and infant periods than infants born at term. While studies have demonstrated that premature infants have decreased adaptive and innate immune responses compared with infants born at term, there has been little investigation into whether this impaired immunity improves and becomes similar to full term infants once the ex-preterm infants reach term-corrected gestational age. There have likewise not been studies to determine whether specific immune markers may predict the risk of developing sepsis. Given the immaturity of the preterm immune system and the many potential infectious and inflammatory insults they are exposed to during the preterm period (infections, poor nutrition, stress, steroid therapy), there is also a possibility that the relative immune deficiency experienced by preterm infants may persist into infancy.

The goal of this study is to determine whether former preterm infants have sustained differences in immunity compared to age-matched controls, which would have significant implications for infection risk and response to vaccination. Additionally, this study hopes to examine whether certain immune system abnormalities make certain babies more likely to have a serious infection. The present study will assess composition and function of T and B cell compartments in preterm and former preterm infants.

02

Conditions studied

  • Sepsis
  • Premature Birth

Keywords

  • Sepsis
  • Prematurity
03

Who can participate

Ages eligible
0 Days to 2 Years
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Both term and preterm infants will be included in the study.

Eligibility criteria

Inclusion Criteria Ex-Preterm Infant Group:

  • Infants born less than 37 weeks gestational age

Exclusion Criteria for Ex-Preterm Infant Group:

  • Infants born greater than 37 weeks gestational age

Inclusion Criteria for Term Infant Group:

  • Infants born greater than 37 weeks gestational age

Exclusion Criteria for Term Infant Group:

  • Infants born less than 37 weeks gestational age
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
40 participants (actual)
Patient registry
No
Biospecimen retention
Samples with dna

Groups and cohorts

  • Preterm Infants

    Blood samples will be obtained from preterm and former preterm infants at birth and then monthly until hospital discharge. The sample would consist of either up to 0.5ml of blood obtained during a requested clinical blood draw, discarded blood, or a dried blood spot specimen. If no discard samples are available and study blood samples need to be obtained instead, this will occur for a maximum period of 6 months and no more than 3ml of blood will be collected over the entire study period.

  • Term Infants

    Blood samples will be obtained from term control infants admitted to the NICU monthly until hospital discharge. The sample would consist of either up to 0.5ml of blood obtained during a requested clinical blood draw, discarded blood, or a dried blood spot specimen. If no discard samples are available and study blood samples need to be obtained instead, this will occur for a maximum period of 6 months and no more than 3ml of blood will be collected over the entire study period.

05

What researchers measure

Primary outcomes

  1. The presence or absence of skewed or altered immune profile in preterm infants compared to infants born at term.

    The present study will assess composition and function of T and B cell compartments in preterm and former preterm infants. Whole blood samples will be separated into serum and cellular components and sera will be used to assess cytokine predominance and measure nutritional markers.

    Time frame: Up to 1 year

Secondary outcomes

  1. Determining whether non-modifiable variables of nutrition status, microbiome composition, or immune repertoire composition predict risk of developing infection during the hospitalization.

    The investigators will measure nutritional status. Whole blood samples will be separated into serum and cellular components and sera will be used to assess cytokine predominance and measure nutritional markers.

    Time frame: Up to 1 year

06

Study locations

1 site
  • Boston Children's Hospital
    Boston, Massachusetts 02115, United States
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03433846
Lead sponsor
Boston Children's Hospital
Responsible party
Amy O'Connell (MD, PhD, Boston Children's Hospital) — Principal investigator
First posted
Feb 15, 2018
Start date
Apr 18, 2019
Primary completion
Jan 1, 2022
Completion
May 1, 2022
Last update
May 20, 2022

Study contacts

Amy O'Connell, MD
principal investigator · Boston Children's Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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