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Cerebral Blood Flow Parameters and Neurobehavioral Development in Infants at Term Age

This study has been completed.
Sponsor:
Information provided by:
National Taiwan University Hospital
ClinicalTrials.gov Identifier:
NCT00676247
First received: May 7, 2008
Last updated: January 19, 2009
Last verified: January 2009
History of Changes
  Purpose

Although several studies have contrasted the hemodynamics of cerebral arteries using cranial Doppler ultrasound between full-term and preterm infants, the assessments were mostly conducted in the first days of life. Furthermore, the clinically significant hemodynamic parameter has been established from a small sample of infants that its validity on other populations remains unclear. Therefore, the purpose of this study is twofold:

  1. to examine the hemodynamics of cerebral arteries in full-term and very low birth weight preterm infants at term age
  2. to assess the validity of the hemodynamic parameters in relation to concurrent neurobehavioral function.

This study will enroll normal full-term infants and very low birth weight preterm infants who have no major neonatal disease. Cranial Doppler ultrasound examination will be performed on all infants at term age. Hemodynamic parameters will include peak systolic velocity, end diastolic velocity, resistance index and pulsatility index for the bilateral anterior cerebral arteries and middle cerebral arteries. Neurobehavioral development will be administered on the same day using the Neonatal Neurobehavioral Examination- Chinese version.


Condition
Premature Birth

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Cross-Sectional
Official Title: Cerebral Blood Flow Parameters and Neurobehavioral Development in Full-Term Infants and Very Low Birth Weight Preterm Infants at Term Age

Resource links provided by NLM:

U.S. FDA Resources

Further study details as provided by National Taiwan University Hospital:

Primary Outcome Measures:
  • Cerebral blood flow velocity [ Time Frame: post-conceptional age=40 weeks ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Neonatal Neurobehavioral Examination [ Time Frame: post-conceptional age=40 weeks ] [ Designated as safety issue: Yes ]

Enrollment: 1
Study Start Date: April 2008
Study Completion Date: May 2008
Primary Completion Date: May 2008 (Final data collection date for primary outcome measure)
Groups/Cohorts
preterm
Very-low-birth-weight preterm infants with brain lesion
full-term
Healthy fullterm infants

Detailed Description:

We estimate the sample size of this study based on the cerebral blood flow velocity data of Kempley's study that showed 7.2 ± 3.5 and 10.7 ± 2.4 cm/s for the MCAs in 13 preterm and 8 full-term infants, respectively. As the power is set at 0.8 and the α level is at 0.05, at least 17 subjects were required for each group. This study will include 20 full-term and 20 VLBW preterm infants who are born at the National Taiwan University Hospital (NTUH) and the Mackay Memorial Hospital (MMH), Taipei, Taiwan. Written informed consent will be obtained from the parents before participation in this study.

Cranial Doppler ultrasound and the NNE-C examinations will be performed within 5 days after birth on full-term infants and at post-menstrual age (PMA) of 40 weeks (± 1 week) on preterm infants in the baby room. If the examination time occurs after hospital discharge, assessment will be conducted in the baby room at NTUH or in the ultrasound examination room at MMH. The examinations will be performed when the babies show stable vital signs in daily activities. The NNE-C examination will be administered one hour prior to feeding to minimize distress. The NNE-C examination will be performed immediately after the ultrasound assessment. The two examinations will be performed by different examiners who were blind to each other's results. During brain Doppler ultrasound examination, each infant will be placed on the back in a baby crib or an incubator with his/her head in midline. Infant's behavioral state will be kept in the behavioral state of 1 (quiet sleep), 2 (active sleep), or 3 (drowsy) on Brazelton's classification to eliminate the impact on cerebral blood flow velocity.

Hemodynamic parameters will include PSV, EDV, RI, and PI from bilateral ACAs and MCAs as obtained by the pulse wave color Doppler. The ACA will be approached through the anterior fontanel on the sagittal plane and its blood flow velocity will be determined at the proximal part. The MCA will be approached under the transverse plane by placing the transducer on the temporal bone below the zygomatic arch. The flow velocity measurements will be obtained by Fourier transform analysis from homogeneous blood flow wave patterns over at least 3 cardiac cycles with good clear signals. Those signals that show complete and similar waveforms in the adjacent cycles and have high magnitudes with visible margin recognized from the background noise will be selected. The RI and PI are the ratio between the different velocities with the formulas: RI = (PSV-EDV) / PSV, PI = (PSV-EDV) / mean velocity. The whole ultrasound examination will take about 10 minutes.

  Eligibility

Ages Eligible for Study:   up to 7 Days
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population

Newborns in the primary care clinic

Criteria

Fullterm group

Inclusion Criteria:

  • birth weight higher than 2,500 g
  • appropriate for gestational age
  • gestation age within 38 and 42 weeks

Exclusion Criteria:

  • chromosomal or congenital abnormalities

Preterm group

Inclusion Criteria:

  • birth weight less than 1,500 g
  • gestational age less than 37 weeks
  • admission at the hospitals within 7 days after birth

Exclusion Criteria:

  • chromosomal or congenital abnormalities
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00676247

Locations
Taiwan
National Taiwan University Hospital
Taipei, Taiwan, 100
Sponsors and Collaborators
National Taiwan University Hospital
Investigators
Study Chair: Suh-Fang Jeng, Doctor National Taiwan University
  More Information

No publications provided

Responsible Party: Suh-Fang Jeng, National Taiwan University
ClinicalTrials.gov Identifier: NCT00676247     History of Changes
Other Study ID Numbers: 200802011R
Study First Received: May 7, 2008
Last Updated: January 19, 2009
Health Authority: Taiwan: Department of Health

Keywords provided by National Taiwan University Hospital:
Ultrasonography
Doppler
Hemodynamics
Neurobehavioral development

Additional relevant MeSH terms:
Premature Birth
Obstetric Labor, Premature
Obstetric Labor Complications
Pregnancy Complications

ClinicalTrials.gov processed this record on May 19, 2013