NCT02774746

Brief Summary

The objective of this study is to investigate the hypothesis that delivery at 35 0/7- 35 6/7 weeks in stable patients with gastroschisis is superior to observation and expectant management with a goal of delivery at 38 0/7 - 38 6/7 weeks. To test this hypothesis, we will complete a randomized, prospective, multi-institutional trial across NAFTNet-affiliated institutions. Patients may be enrolled in the study any time prior to 33 weeks, but will be randomized at 33 weeks to delivery at 35 weeks or observation with a goal of 38 weeks. The primary composite outcome will include stillbirth, neonatal death prior to discharge, respiratory morbidity, and need for parenteral nutrition at 30 days.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
300

participants targeted

Target at P75+ for not_applicable

Timeline
35mo left

Started Feb 2018

Longer than P75 for not_applicable

Geographic Reach
1 country

38 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress74%
Feb 2018Mar 2029

First Submitted

Initial submission to the registry

May 11, 2016

Completed
6 days until next milestone

First Posted

Study publicly available on registry

May 17, 2016

Completed
1.8 years until next milestone

Study Start

First participant enrolled

February 23, 2018

Completed
11.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 31, 2029

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 31, 2029

Last Updated

May 4, 2026

Status Verified

April 1, 2026

Enrollment Period

11.1 years

First QC Date

May 11, 2016

Last Update Submit

April 28, 2026

Conditions

Outcome Measures

Primary Outcomes (1)

  • Comparison of the proportion of the primary composite outcome (occurrence of any of the 3 clinical risks: IUFD, neonatal death, and sepsis) between groups as estimated from the ITT population.

    The primary outcome is the composite endpoint combining the following three clinical risks: (1) intrauterine fetal demise, (2) neonatal/infant death prior to neonatal intensive care unit (NICU) discharge, (3) sepsis. The probability of the composite endpoint will be compared between groups as defined by the ITT population using a one-sided test at a 2.3% nominal significance level for the alternative hypothesis that the experimental early delivery group has lower probability of the composite endpoint compared to term delivery group. The nominal significance level will be adjusted based on the timing of the interim analysis if different from the original plan. The Wald test for two proportions will be used. We will report the estimated difference in the probabilities along with the Wald confidence interval using the nominal significance level.

    Date of consent until NICU Discharge. Discharge dates for patients vary and depend on each individual's recovery progress, medical needs, and overall condition. In general, this entire time frame can take up to 30 weeks.

Study Arms (2)

35-week delivery group

ACTIVE COMPARATOR

Subjects to be delivered at 35 0/7 weeks through 35 6/7 weeks.

Other: 35-week delivery

38-week delivery group

ACTIVE COMPARATOR

Subjects to be expectantly managed to spontaneous delivery, delivered by 38 0/7 weeks through 38 6/7 weeks.

Other: 38-week delivery

Interventions

Induction at 35 weeks gestational age

35-week delivery group

Observation to spontaneous delivery or induction at 38 weeks gestational age

38-week delivery group

Eligibility Criteria

Age18 Years+
Sexfemale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Speak English or Spanish
  • Age of ≥18 years old
  • Have a diagnosis of an isolated fetal gastroschisis confirmed via sonogram at ≤33 weeks gestation
  • Have a singleton pregnancy
  • Capable of providing written informed consent for study participation
  • Established Estimated Date of Confinement (EDC) prior to 22 0/7 weeks GA by last menstrual period (LMP) with ultrasound confirmation or ultrasound dating when LMP is unknown.

You may not qualify if:

  • Subjects will be excluded from enrollment for any of the following criteria
  • Fetal anomaly unrelated to gastroschisis, such as a chromosomal abnormality or another congenital structural abnormality (if known; no additional testing required for research participation)
  • Severe intrauterine growth restriction / fetal growth restriction (defined as growth below the 5th percentile for gestational age)
  • Maternal history of previous stillbirth (intrauterine fetal demise)
  • Maternal history of spontaneous preterm (\<36 weeks) delivery
  • Maternal cervical length \< 25 mm prior to 24 weeks of gestation if documented
  • Maternal hypertension
  • Maternal insulin-dependent diabetes
  • Prenatal care initiated after 24 weeks of gestation
  • An active case of COVID-19 (confirmed by a positive test for COVID-19) that is not recovered (confirmed by a negative test for COVID-19) by the date of randomization
  • Unstable pregnancy defined as meeting any of the following criteria
  • Abnormal amniotic fluid volume defined as oligohydramnios or polyhydramnios where the maximal vertical pocket (MVP) is \< 2 cm or \> 8 cm in the third trimester, respectively
  • Umbilical artery Dopplers with S/D ratio or resistive index (RI) \> 97th percentile for age with or without absent or reversed end diastolic flow
  • Non-stress test (NST) or biophysical profile (BPP) deemed non-reassuring by treating clinician
  • Concurrent enrollment in another study that requires either a treatment or intervention which would either alter the delivery plan or potentially influence the maternal, fetal, and neonatal outcomes of this study
  • +3 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (38)

Phoenix Children's Hospital

Phoenix, Arizona, 85016, United States

WITHDRAWN

Loma Linda University Children's Hospital

Loma Linda, California, 92354, United States

RECRUITING

Lucile Packard Children's Hospital Stanford

Stanford, California, 94305, United States

RECRUITING

Children's Hospital of Colorado

Aurora, Colorado, 80045, United States

RECRUITING

Connecticut Children's Medical Center

Hartford, Connecticut, 06106, United States

RECRUITING

Nemours Children's Hospital, Delaware

Wilmington, Delaware, 19803, United States

RECRUITING

University of South Florida & Tampa General Hospital

Tampa, Florida, 33606, United States

RECRUITING

Emory University

Atlanta, Georgia, 30322, United States

RECRUITING

Ann & Robert H. Lurie Children's Hospital of Chicago

Chicago, Illinois, 60611, United States

RECRUITING

OSF St. Francis Medical Center

Peoria, Illinois, 61637, United States

RECRUITING

Riley Children's Hospital

Indianapolis, Indiana, 46202, United States

RECRUITING

Norton Healthcare, Inc.

Lousiville, Kentucky, 40207, United States

RECRUITING

University of Maryland, Baltimore

Baltimore, Maryland, 21201, United States

RECRUITING

Johns Hopkins Hospital

Baltimore, Maryland, 21287, United States

RECRUITING

Brigham and Women's Hospital & Boston Children's Hospital

Boston, Massachusetts, 02115, United States

RECRUITING

Beth Israel Deaconess Medical Center

Boston, Massachusetts, 02215, United States

RECRUITING

CS Mott Children's & Von Voigtlander Women's Hospital, Michigan Medicine

Ann Arbor, Michigan, 48109, United States

RECRUITING

Children's MN, Midwest Fetal Care Center

Minneapolis, Minnesota, 55404, United States

RECRUITING

Children's Mercy Hospital

Kansas City, Missouri, 64108, United States

RECRUITING

St. Louis University, SSM Health Cardinal Glennon Children's Hospital & SSM Health St. Mary's Hospital

St Louis, Missouri, 63104, United States

RECRUITING

Washington University in St. Louis & St. Louis Children's Hospital

St Louis, Missouri, 63110, United States

RECRUITING

Columbia University Irving Medical Center

New York, New York, 10032, United States

RECRUITING

New York Presbyterian - Weill Cornell Medicine

New York, New York, 10065, United States

RECRUITING

University of Rochester Medical Center

Rochester, New York, 14642, United States

RECRUITING

University of North Carolina Hospitals

Chapel Hill, North Carolina, 27599, United States

RECRUITING

Cleveland Clinic

Cleveland, Ohio, 44195, United States

RECRUITING

Oregon Health and Science University

Portland, Oregon, 97239, United States

RECRUITING

Women & Infants Hospital/Rhode Island Hospital (Hasbro Children's)

Providence, Rhode Island, 02905, United States

RECRUITING

Vanderbilt University Medical Center

Nashville, Tennessee, 37232, United States

RECRUITING

Cook Children's Medical Center

Fort Worth, Texas, 76104, United States

RECRUITING

University of Texas Medical Branch Galveston

Galveston, Texas, 77555, United States

RECRUITING

The University of Texas Health Science Center at Houston

Houston, Texas, 77030, United States

RECRUITING

The Woman's Hospital of Texas / Obstetrix Maternal-Fetal Medicine Specialists of Houston

Houston, Texas, 77054, United States

WITHDRAWN

Christus Children's / Baylor College of Medicine

San Antonio, Texas, 78207, United States

RECRUITING

University of Utah & Primary Children's Hospital

Salt Lake City, Utah, 84123, United States

RECRUITING

University of Virginia

Charlottesville, Virginia, 22903, United States

RECRUITING

University of Wisconsin - Madison

Madison, Wisconsin, 53715, United States

RECRUITING

Medical College of Wisconsin & Children's Wisconsin

Milwaukee, Wisconsin, 53226, United States

RECRUITING

MeSH Terms

Conditions

Gastroschisis

Interventions

Parturition

Condition Hierarchy (Ancestors)

Musculoskeletal AbnormalitiesMusculoskeletal DiseasesCongenital AbnormalitiesCongenital, Hereditary, and Neonatal Diseases and AbnormalitiesHernia, AbdominalHerniaPathological Conditions, AnatomicalPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

PregnancyReproductionReproductive Physiological PhenomenaReproductive and Urinary Physiological Phenomena

Study Officials

  • Amy Wagner, MD

    Medical College of Wisconsin

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Rachel Bailey, BS

CONTACT

Sam Oswald, MS

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor, Pediatric Surgery

Study Record Dates

First Submitted

May 11, 2016

First Posted

May 17, 2016

Study Start

February 23, 2018

Primary Completion (Estimated)

March 31, 2029

Study Completion (Estimated)

March 31, 2029

Last Updated

May 4, 2026

Record last verified: 2026-04

Locations