Streptococcal Infection and Respiratory Distress in Newborns
|First Received Date ICMJE||February 10, 2008|
|Last Updated Date||November 27, 2013|
|Start Date ICMJE||February 2008|
|Primary Completion Date||Not Provided|
|Current Primary Outcome Measures ICMJE
||Newborns with respiratory distress who are born to mothers of group B streptococcal carriers have detectable levels of bacterial phospholipids in their serum or their maternal and cord serum samples|
|Original Primary Outcome Measures ICMJE||Not Provided|
|Change History||Complete list of historical versions of study NCT00612937 on ClinicalTrials.gov Archive Site|
|Current Secondary Outcome Measures ICMJE
||Newborns born to mothers who are group B streptococcal carriers are at higher risk of developing respiratory distress at birth.|
|Original Secondary Outcome Measures ICMJE||Not Provided|
|Current Other Outcome Measures ICMJE||Not Provided|
|Original Other Outcome Measures ICMJE||Not Provided|
|Brief Title ICMJE||Streptococcal Infection and Respiratory Distress in Newborns|
|Official Title ICMJE||Respiratory Distress of the Newborn and Its Relationship to Group B Streptococcal Colonization|
This study will evaluate whether babies are more at risk of developing breathing problems if their mothers carry group B streptococci (GBS) in vagina/rectum, and whether the breathing problem is due to phospholipids released by the GBS. About one in five pregnant women carry GBS in their vagina/rectum. Mothers who carry these bacteria are given antibiotics during labor to prevent infection in the baby. However, recently it has been suspected that even without blood stream infection, the chemicals released by GBS, called phospholipids, might lead to breathing problems.
Women at 32 or more weeks of pregnancy who deliver at Ben Taub Hospital and St. Luke s Episcopal Hospital in Houston, Texas, and Alta Bates Summit Medical Center in Oakland, California, may be eligible for this study.
Mothers undergo the following procedures:
Newborns undergo the following procedures:
Phospholipids from the group B streptococcal (GBS) cell wall cause pulmonary hypertension in experimental animals. We hypothesize that newborns colonized with GBS receive bacterial phospholipids leading to pulmonary hypertension and respiratory distress. When exposed to penicillin (beta-lactam), Streptococcus mutans releases phospholipids immediately. An analysis of 1610 colonized newborns from the NICHD GBS study conducted in six academic centers from 1995 to 1999 showed that 8.8% of GBS colonized newborns greater than or equal to 32 weeks gestation had signs of respiratory distress as compared to 1-3% observed in general newborn populations, and that beta-lactam use during labor was associated with 2.62 fold increase in respiratory distress in the colonized newborns. These findings support the association of neonatal respiratory distress with GBS colonization and with penicillin use during labor. These data however require confirmation.
We now plan to conduct a prospective study to relate the levels of serum bacterial phospholipids to the occurrence of respiratory distress in newborns of mother colonized GBS. This study will also evaluate the effect of beta-lactam use during labor on the release of phospholipids and therefore the occurrence of respiratory distress in newborns of mothers colonized with GBS. The study will be conducted at the Baylor College of Medicine and Oakland Children s Hospital and Research Center. Serum phospholipid levels will be measured in newborns with respiratory distress, newborns of mothers colonized by GBS, treated or untreated with beta-lactam during labor.
|Study Type ICMJE||Observational|
|Study Design ICMJE||Time Perspective: Prospective|
|Target Follow-Up Duration||Not Provided|
|Sampling Method||Not Provided|
|Study Population||Not Provided|
|Intervention ICMJE||Not Provided|
|Study Group/Cohort (s)||Not Provided|
* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
|Recruitment Status ICMJE||Completed|
|Estimated Enrollment ICMJE||16000|
|Completion Date||Not Provided|
|Primary Completion Date||Not Provided|
|Eligibility Criteria ICMJE||
All women who are admitted to labor and delivery room at greater than or equal to 32 weeks gestation will be approached for obtaining consent to participate in this study.
Newborns with severe or fatal congenital anomaly such as gastroschisis, congenital diaphragmatic hernia, tracheoesophageal fistula, transition of the great arteries, coarctation of aorta, myelomeningocele, and omphalocele will be excluded from the study.
|Accepts Healthy Volunteers||No|
|Contacts ICMJE||Contact information is only displayed when the study is recruiting subjects|
|Location Countries ICMJE||United States|
|NCT Number ICMJE||NCT00612937|
|Other Study ID Numbers ICMJE||999908069, 08-CH-N069|
|Has Data Monitoring Committee||Not Provided|
|Responsible Party||Not Provided|
|Study Sponsor ICMJE||Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)|
|Collaborators ICMJE||Not Provided|
|Information Provided By||National Institutes of Health Clinical Center (CC)|
|Verification Date||January 2013|
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