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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04877119
Other study ID # 14905
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date October 14, 2019
Est. completion date December 31, 2022

Study information

Verified date May 2021
Source Azienda Ospedaliero, Universitaria Pisana
Contact Cristina Bianchi, MD, PhD
Phone +39050995136
Email c.bianchi@ao-pisa.toscana.it
Is FDA regulated No
Health authority
Study type Observational [Patient Registry]

Clinical Trial Summary

The ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to placental growth factor (PlGF) is elevated in pregnant women before the clinical onset of preeclampsia and can be used to predict the preeclampsia. However, its predictive value in pregnancy complicated by gestational diabetes is unclear. This study purposes are to validate a ratio of serum sFlt-1 to PlGF that would be predictive of the absence or presence of preeclampsia in the short term in women with singleton pregnancies complicated by diabetes in whom preeclampsia was suspected, and to evaluate the relationship among sFlt-1 to PlGF and placental histopathological alterations.


Description:

Single center, observational, prospective study designed to validate a cutoff point of the sFlt-1:PlGF ratio for the prediction of the short-term absence or presence of preeclampsia in pregnancy complicated by gestational diabetes (GDM). GDM women will be recruited at diabetes screening time (16-18 or 24-27 gestational weeks), performed according with the Italian National Guidelines by 75g - 2 hour Oral Glucose Tolerance Test. GDM will be defined according with International Association of Diabetes and Pregnancy Study Groups/World Health Organization 2013 criteria. A standardized medical history will be obtained in all the women at the time of their first visit, collecting data about maternal age, parity, last menstruation, pre-gestational weight, history of GDM, hypertension and macrosomia in previous pregnancies, family history of diabetes mellitus, education and employment. Moreover, during their visit, the women's weights were taken and their blood pressure measured. Blood samples for assessments of sFlt-1:PlGF ratio will be collected at visit 1 (baseline visit) and every 30±7 days after the previous visit until 36 gestational week (for a maximum of 4 determinations). At baseline and at each follow-up visits update of medical history, clinical assessments, laboratory testing and pregnancy evolution will be evaluated. During pregnancy all women will be receive standard diabetes and obstetric care, according with national guidelines. Diagnostic criteria for preeclampsia will be a new onset of both hypertension (systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or both) and proteinuria (2+ protein or greater on dipstick urinalysis, ≥300 mg of protein per 24-hour urine collection, ≥30 mg /dl of protein in a spot urine sample, or a ratio of protein to creatinine of ≥30 mg/mmol) after 20 weeks of gestation. Only cases that met these prespecified criteria will be included in the analyses. At delivery, data items on maternal body weight at the end of pregnancy, time and mode of delivery, newborn bodyweight, preeclampsia as well as other maternal and fetal outcomes will be collected. Placental histopathological alterations will be detected in women who delivery by planned Cesarian section.


Recruitment information / eligibility

Status Recruiting
Enrollment 500
Est. completion date December 31, 2022
Est. primary completion date March 31, 2022
Accepts healthy volunteers Accepts Healthy Volunteers
Gender Female
Age group 18 Years and older
Eligibility Inclusion Criteria: - Age > 18 years - Diagnosis of GDM in the current pregnancy Exclusion Criteria: - Twin pregnancies - Pre-pregnancy diabetes (type 1 or type 2 diabetes) - Gestosis already diagnosed during the current pregnancy

Study Design


Locations

Country Name City State
Italy Azienda Ospedaliero-Universitaria Pisana - U.O. Malattie Metaboliche e Diabetologia Pisa PI

Sponsors (1)

Lead Sponsor Collaborator
Azienda Ospedaliero, Universitaria Pisana

Country where clinical trial is conducted

Italy, 

Outcome

Type Measure Description Time frame Safety issue
Primary Predictive SFLT-1 / PLGF ratio cat-off point for preeclampsia Evaluation of a specific SFLT-1 / PLGF ratio cat-off point for women with diabetes during pregnancy (pre-pregnancy or gestational) in the prediction of preeclampsia 25 weeks
Secondary Correlation between SFLT-1 / PLGF ratio and placental histopathology Correlation between SFLT-1 / PLGF ratio and rate of placental histopathological alterations in pregnancy complicated by diabetes (pre-pregnancy or gestational) 25 weeks
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