NCT04890886

Brief Summary

There is limited knowledge about the extent of the impact of maternal metabolic diseases (MD) and/or alterations in maternal serum lipid content upon neonatal lipid distribution and phenotypes. This observational feasibility study aims to investigate the effect of maternal MD on fat distribution, lipid content and metabolic phenotype of different neonatal tissues. We will explore whether differences in tissue fat distribution and lipid content are observed in the neonates of women with MD during pregnancy, compared to those who have a healthy, uncomplicated pregnancy and if there are changes in how the different tissues work (e.g. cardiac function). If there is evidence to show that there are alterations during pregnancy in children of women with MD, this will help inform potential interventions to ensure optimal child health.

Trial Health

35
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
80

participants targeted

Target at P50-P75 for all trials

Timeline
Completed

Started Jun 2021

Typical duration for all trials

Status
unknown

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

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 13, 2021

Completed
5 days until next milestone

First Posted

Study publicly available on registry

May 18, 2021

Completed
14 days until next milestone

Study Start

First participant enrolled

June 1, 2021

Completed
2.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2023

Completed
Last Updated

May 18, 2021

Status Verified

May 1, 2021

Enrollment Period

2.5 years

First QC Date

May 13, 2021

Last Update Submit

May 13, 2021

Conditions

Keywords

type 1 diabetestype 2 diabetesgestational diabetesintrahepatic cholestasis of pregnancymetabolic disease in pregnancybrown adipose tissuewhite adipose tissuecardiac functionECGliver functionthermal imaging

Outcome Measures

Primary Outcomes (1)

  • Assessment of the distribution of adipose tissue

    To perform imaging and biochemical studies to determine whether maternal metabolic disease alters the distribution of adipose tissue (SAT, VAT, BAT) of the fetuses and neonates of women with MD during pregnancy compared to neonates of women who had a healthy pregnancy.

    30 months

Secondary Outcomes (4)

  • Assessment of skeletal muscle, heart and liver

    30 months

  • Assessment of the function of adipose tissue

    30 months

  • Assessment of cardiac function and rhythm

    30 months

  • Thermal assessment

    30 months

Study Arms (4)

Pre-existing Type 1 Diabetes and Type 2 Diabetes

Women with type 1 diabetes and type 2 diabetes diagnosed prior to pregnancy

Diagnostic Test: Thermal imagingDiagnostic Test: EchocardiogramDiagnostic Test: ECGDiagnostic Test: MRI scanDiagnostic Test: Serum blood markers

Gestational Diabetes

Women with gestational diabetes diagnosed in pregnancy by the oral glucose tolerance test

Diagnostic Test: Thermal imagingDiagnostic Test: EchocardiogramDiagnostic Test: ECGDiagnostic Test: MRI scanDiagnostic Test: Serum blood markers

Intrahepatic cholestasis of pregnancy

Women with intrahepatic cholestasis of pregnancy

Diagnostic Test: Thermal imagingDiagnostic Test: EchocardiogramDiagnostic Test: ECGDiagnostic Test: MRI scanDiagnostic Test: Serum blood markers

Control

Women without metabolic disease in pregnancy

Diagnostic Test: Thermal imagingDiagnostic Test: EchocardiogramDiagnostic Test: ECGDiagnostic Test: MRI scanDiagnostic Test: Serum blood markers

Interventions

Thermal imagingDIAGNOSTIC_TEST

Use of a thermal imaging cameral to measure brown and white adipose tissue function

ControlGestational DiabetesIntrahepatic cholestasis of pregnancyPre-existing Type 1 Diabetes and Type 2 Diabetes
EchocardiogramDIAGNOSTIC_TEST

Echocardiographic imaging of the fetal heart to assess ventricular function

ControlGestational DiabetesIntrahepatic cholestasis of pregnancyPre-existing Type 1 Diabetes and Type 2 Diabetes
ECGDIAGNOSTIC_TEST

ECG of the fetus and the neonate to look at the cardiac electrical activity

ControlGestational DiabetesIntrahepatic cholestasis of pregnancyPre-existing Type 1 Diabetes and Type 2 Diabetes
MRI scanDIAGNOSTIC_TEST

MRI scan of the neonate to assess adipose tissue, liver architecture and cardiac structure and function

ControlGestational DiabetesIntrahepatic cholestasis of pregnancyPre-existing Type 1 Diabetes and Type 2 Diabetes
Serum blood markersDIAGNOSTIC_TEST

Serum sample taken from mother before birth and umbilical cord or neonatal blood spot at birth to assess glucose levels / lipid levels and lipidomics and cardiac function (using NTproBNP) as a marker

ControlGestational DiabetesIntrahepatic cholestasis of pregnancyPre-existing Type 1 Diabetes and Type 2 Diabetes

Eligibility Criteria

Age16 Years - 45 Years
Sexfemale
Age GroupsChild (0-17), Adult (18-64)
Sampling MethodNon-Probability Sample
Study Population

Pregnant women with metabolic disease in pregnancy or healthy controls. The neonates that will be studied can be of any sex/gender for inclusion in the study.

You may qualify if:

  • Pregnant women aged between 16 and 45 years old.
  • Women with GDM diagnosed at 26+0 to 30+6 weeks' gestation in accordance with the NICE guidelines Or
  • Pregnant women with pre-existing type 1 or type 2 diabetes mellitus Or
  • Women diagnosed with ICP at any stage of pregnancy
  • Fluent in English or presence of an interpreter or translation service (i.e. telephone translation services) at all visits.
  • Singleton pregnancy.
  • Willing and able to give written informed consent and comply with requirements of the study protocol
  • Planned antenatal, intrapartum and postpartum care at the participating centre (i.e. not planning to move before delivery)

You may not qualify if:

  • \. Known fetal congenital abnormality on ultrasound requiring fetal medicine input (excluding congenital heart disease).
  • Known fetal congenital abnormality on ultrasound requiring fetal medicine input (excluding congenital heart disease).
  • Significant pre-pregnancy co-morbidities that increase risk in pregnancy, for example renal failure, severe liver disease, transplantation, cardiac failure, psychiatric conditions requiring in-patient admission (within previous year) in the opinion of the responsible clinician or the CI.
  • Significant co-morbidity in the current pregnancy, nephropathy (estimated GFR \<60ml/min), other physical or psychological conditions likely to interfere with the conduct of the study and/or interpretation of the study results in the opinion of the responsible clinician or the CI. (This does not include diabetes mellitus).
  • History of bariatric surgery.
  • Hypertension requiring treatment pre-pregnancy / in pregnancy.
  • Prescribed other medications that affect insulin sensitivity prior to OGTT for women diagnosed with GDM (oral antihyperglycemic agents, antipsychotic drugs, supraphysiological doses of steroids).
  • For the baby after birth: Not meeting the safety criteria to undergo MRI scan (e.g. metal implants, non MRI compatible devices, metal fragments in the body). \[ The mother will not have an MRI scan\].

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Biospecimen

Retention: SAMPLES WITHOUT DNA

Serum samples to measure metabolic function and measures of cardiac function

MeSH Terms

Conditions

Diabetes MellitusIntrahepatic Cholestasis of PregnancyMetabolic DiseasesDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2Diabetes, Gestational

Interventions

EchocardiographyElectrocardiographyMagnetic Resonance Imaging

Condition Hierarchy (Ancestors)

Glucose Metabolism DisordersNutritional and Metabolic DiseasesEndocrine System DiseasesAutoimmune DiseasesImmune System DiseasesPregnancy ComplicationsFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital Diseases

Intervention Hierarchy (Ancestors)

Cardiac Imaging TechniquesDiagnostic ImagingDiagnostic Techniques and ProceduresDiagnosisUltrasonographyHeart Function TestsDiagnostic Techniques, CardiovascularElectrodiagnosisTomography

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 13, 2021

First Posted

May 18, 2021

Study Start

June 1, 2021

Primary Completion

December 1, 2023

Study Completion

December 1, 2023

Last Updated

May 18, 2021

Record last verified: 2021-05