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NCT Number: NCT06534307

Long-term Follow-up of Children Born in the PETN Studies

In every 10th pregnancy, the child in the uterus is insufficiently nourished, a so-called growth retardation. This occurs when the child cannot reach its growth potential due to an undersupply in the uterus. This inadequate supply is considered a developmental cause for the later development of physical diseases like cardiovascular diseases, sugar metabolism disorders and obesity as well as mental developmental problems (for example problems in cognitive skills, deficits in language development, concentration and attention).

From 2002 to 2008, 111 patients with impaired placental blood flow were included in a small study and treated with Pentalong or placebo. From 2017 to 2022, the positive effects of the study treatment were tested on a larger number of patients. A total of 317 pregnant women were included at 14 participating study centers in Germany.

In this follow-up study, the development of the children born in the two studies will be examined. The study consists of two independent parts: firstly, questionnaires are answered by the former participants and secondly, an on-site visit is carried out to check the physical and mental health of the child.

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Key information

Age range

6 year–18 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Universitäts-Frauenklinik Tübingen, Tübingen, Baden-Wurttemberg, Germany

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About this study

Pregnancies in which impaired uterine blood flow is detected by Doppler measurements during routine examinations in the second trimester are at high risk of developing fetal growth restriction (FGR). FGR affects 10% of pregnancies and is the leading cause of perinatal mortality and morbidity. In addition, intrauterine growth restriction places a lifelong burden on the physical and mental health of affected children. Epidemiological studies have shown that children with FGR have an increased risk of developing type 2 diabetes mellitus, hypertension, dyslipidemia and a high BMI. In addition, the affected children show disorders in hormonal balance and pubertal development as well as specific impairments of various cognitive and neurocognitive functions. There is also a link between FGR and lower cognitive ability in preschool children, school-age children and young adults, as well as lower communication, language and reading skills in school-age children. Neuronal development (e.g. EEG frequency spectra, resting-state networks) and executive functions are also impaired by FGR.

In the follow-up study, the children will be examined from the age of 6. Here, the effects of PETN on the development of children of women with high-risk pregnancies can be further investigated and a comparative study of growth-retarded and normal-growth children can also be carried out.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • mothers participation in one of the PETN studies
  • age above 5 years
  • completion of questionnaires for self reported data
  • written consent for physical examination

Exclusion criteria

- only physical examination:

  • physical and mental states preventing physical examination

Treatment and study plan

Questionnaire Child Behaviour Checklist

Behavioral

The Child Behavior Checklist comprises items assigned to 8 subscales describing various behavioral areas. These subscales can be summed up to scores for internalizing and externalizing problems as well as a total score. Checklist scores are reported on a T-scale. Range of T-scale from scores 20 to 100 (average performance between scores 40 and 60). Higher scores mean higher amount of problems.

Other names: CBCL/6-18R

Questionnaire Young Self Report

Behavioral

The Questionnaire Young Self Report comprises items assigned to 8 subscales describing various behavioral areas. These subscales can be summed up to scores for internalizing and externalizing problems as well as a total score.

Other names: YSR/11-18R

Physical Examination

Diagnostic Test

physical development examination including height (in cm), weight (in g) and tanner states

metabolic examination

Diagnostic Test

metabolic development using blood analysis including blood components, metabolic parameters (Glucose, HbA1c, cholestrol)

Questionnaire Reynolds Intellectual Assessment Scales and Screening

Behavioral

The RIAS is standardized intelligence test. The RIAS provides an "Total Intelligence Index" (GIX, estimate of the general intelligence/g-factor), Verbal Intelligence Index (VIX) and the Nonverbal Intelligence Index (NIX). Test scores are reported on a T-scale. Range of T-scale from scores 20 to 100 (average performance between scores 40 and 60). Higher scores mean better cognitive performance.

Other names: RIAS

Electroencephalogram

Diagnostic Test

neurocognitive development

Other names: EEG

Questionnaire Movement Assessment Battery for Children

Other

The M-ABC-2 is an standardized test to assess the motoric development. Adding up subscores addressing manual dexterity, aiming and catching, and balance delivers a total score of the motoric performance.

Test scores are reported on a T-scale. Range of T-scale from scores 20 to 100 (average performance between scores 40 and 60). Higher scores mean better performance.

Other names: M-ABC-2

Questionnaire Continuous Performance Test

Other

The CPT measures selective attention, sustained attention as well as impulsive behavior. Checklist scores are reported on a T-scale. Range of T-scale from scores 20 to 100 (average performance between scores 40 and 60). Higher scores mean worse performance.

Other names: CPT

Questionnaire Diagnostic System for Mental Disorders

Other

The FBB-ADHS assesses a total score for ADHD-like behavior and subscores for the symptom trias of ADHD (attention deficit, motoric hyperactivity as well as impulsive behavior, Questionnaire scores are reported on a T-scale. Range of T-scale from scores 20 to 100 (average performance between scores 40 and 60). Higher scores mean higher amount of symptoms.

Other names: FBB-ADHS

kidney function tests

Diagnostic Test

urine examination (proteomics, cytokines, lipidomics)

Questionnaire Five to Fifteen

Other

The FTF 5-15R is a questionnaire to evaluate the child's developmental outcome in different areas of everyday life (cognition, language, and motor impairment as well as social, emotional, and behavioral problems). Individual item scores are added up per area and divided by the number of items. This results in a common scale value. Range of Percentile scores from 0 to 100 (0-90: no developmental problem; 90 and higher: hint for developmental problem). Higher scores mean worse developmental outcome.

Other names: FTF 5-15R

cardiovacular examination

Diagnostic Test

measurement of pulse wave velocity

Other names: Arteriograph

Primary outcomes

  1. childrens behaviour

    Time frame: up to 2 years after study inclusion

    total score of either CBCL/16-18R or YSR/11-18R

Secondary outcomes

  1. physical development height

    Time frame: up to 2 years after study inclusion

    height of the child in cm

  2. physical development weight

    Time frame: up to 2 years after study inclusion

    weight of the child in kg

  3. age appropriate development

    Time frame: up to 2 years after study inclusion

    age appropriate development documented as "yes or no" question in german routine examination plan ("Kinderuntersuchungsheft") in the last 6 years at caregivers

  4. cognitive, motoric, and exectuve function

    Time frame: up to 2 years after study inclusion

    scores of the eight domains of the FTF 5-15-R

  5. physical development

    Time frame: age above 10 years

    self reported tanner states

  6. cardiovascular development

    Time frame: age of 6 to 8 years

    pulse wave velosity

  7. IQ development

    Time frame: age of 6 to 8 years

    scores of RIAS test

  8. motoric development

    Time frame: age of 6 to 8 years

    total score of M-ABC-2

  9. attention behaviour

    Time frame: age of 6 to 8 years

    scores of the four domains of the cpt

  10. symptoms of attention and activity disorders

    Time frame: age of 6 to 8 years

    total scores of DISYPS-III

  11. neurocognitive development

    Time frame: age of 6 to 8 years

    results of EEG power measurement in alpha band

  12. neurocognitive development

    Time frame: age of 6 to 8 years

    results of EEG power measurement in beta band

  13. neurocognitive development

    Time frame: age of 6 to 8 years

    results of EEG power measurement in gamma band

  14. neurocognitive development

    Time frame: age of 6 to 8 years

    results of EEG power measurement in delta band

  15. neurocognitive development

    Time frame: age of 6 to 8 years

    results of EEG power measurement in theta band

  16. epigenetic analysis

    Time frame: age of 6 to 8 years

    DNA-methylation

Sponsors and collaborators

Lead sponsor

Jena University Hospital

Other

Registry information

Official study title

Langzeiteffekt Einer Pentaerithrityltetranitrat (PETN)-Behandlung in Der Schwangerschaft - Nachbeobachtung Der Kinder Der PETN-Studien

Acronym: LOOP

Important dates

Study start
2024
Primary completion
2027
Study completion
2028
First posted
Aug 2, 2024
Registry last updated
Aug 2, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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