Labor Onset Clinical Trial
Official title:
Pregnancy and Latent Labor Biomarkers and Symptoms to Predict Cervical Dilation at Hospital Admission.
Verified date | June 2020 |
Source | Oregon Health and Science University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
The proposed pilot investigation is a prospective, observational study of 300 healthy
nulliparous women with spontaneous term labor onset. The specific aims of this study are to:
Aim #1: Characterize IL-8 (pro-inflammatory biomarker), basal body temperature, maternal
heart rate, and electrical activity of the uterus prior to spontaneous onset of labor through
the onset of active labor among nulliparous women. IL-8 will be quantified weekly, daily
basal body temperature, as well as continuous maternal heart rate and electrical activity of
the uterus throughout the transition from late pregnancy into active labor.
Aim #2: Characterize latent labor symptoms among nulliparous women in spontaneous labor.
Using Likert scale, childbirth-specific, symptom-specific PROMIS measures,45 and open-ended
questions will be quantified and characterize latent labor symptoms (e.g., intensity,
frequency) and identify relevant themes.
Aim #3: Characterize trajectories of labor biomarkers and latent labor symptoms across latent
labor duration. A modified growth mixture modeling approach to quantify subgroup phenotypes
among nulliparous women in spontaneous latent labor will be employed.
Hypothesis 3.1. There will be significant congruence between higher biomarkers (e.g., higher
IL-8, more uterine electrical activity) and symptoms that are more intense and frequent.
Hypothesis 3.2. At least two classes of laboring women with distinct trajectories of change
in biomarkers and symptoms can be identified and will be associated with cervical dilation at
hospital admission.
Exploratory Aim: Characterize biomarkers among nulliparous women with spontaneous labor onset
vs. nulliparous women requiring labor induction for post-term gestation. Weekly IL-8, daily
basal body temperature, as well as continuous maternal heart rate and electrical activity of
the uterus throughout the transition from late pregnancy into active labor between those
whose labor begins spontaneously and those whose labors are induced for post-term gestation
will be quantified.
Exploratory Hypothesis. There will be different biomarker patterns between women with
spontaneous labor onset vs. those without.
The Standard descriptive and inferential statistics as well as growth mixture modeling for
quantitative aims will be used. The investigators will use thematic development for
qualitative aims.
Status | Active, not recruiting |
Enrollment | 300 |
Est. completion date | June 1, 2021 |
Est. primary completion date | June 1, 2021 |
Accepts healthy volunteers | |
Gender | Female |
Age group | 20 Years to 39 Years |
Eligibility |
Inclusion Criteria: 1. Nulliparous 2. Maternal age of at least 20 years of age. 3. Maternal age of no greater than 39 years of age. 4. Viable, term pregnancy: = 37 weeks gestation at time of signing study consent. 5. Able to understand and provide an informed consent. 6. Able to understand English. Exclusion Criteria: 1. Multiple gestation (i.e., carrying >1 fetus) 2. Managing complex comorbidities (e.g., preeclampsia) 3. Documented fetal congenital anomalies 4. Preterm labor and birth 5. Persistent breech fetal position at term 6. Fetal death prior to the onset of labor 7. Any indication for planned cesarean birth (e.g., placenta previa) 8. Induction of labor for medical indication (e.g., oligohydramnios) |
Country | Name | City | State |
---|---|---|---|
United States | OHSU | Portland | Oregon |
Lead Sponsor | Collaborator |
---|---|
Oregon Health and Science University | Bloomlife Technologies, Medical Research Foundation, Oregon, OHSU School of Nursing |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Change in Basal body temperature comparison in spontaneous labor vs induction | Quantified weekly basal body temperature comparison throughout the transition from late pregnancy into active labor between those whose labor begins spontaneously and those whose labors are induced for post-term gestation. | week 37, week 38, week 39, week 40, week 41, week 42, upon admission for labor to OHSU | |
Other | Changes in continuous maternal heart rate comparison in spontaneous labor vs induction | Quantified maternal heart rate comparison throughout the transition from late pregnancy into active labor between those whose labor begins spontaneously and those whose labors are induced for post-term gestation. | week 37, week 38, week 39, week 40, week 41, week 42, upon admission for labor to OHSU | |
Other | Changes in IL-8 comparison in spontaneous labor vs induction | Quantified weekly IL-8 comparison throughout the transition from late pregnancy into active labor between those whose labor begins spontaneously and those whose labors are induced for post-term gestation. | week 37, week 38, week 39, week 40, week 41, week 42, upon admission for labor to OHSU | |
Primary | Change in Interleukin-8 (IL-8) expression during latent phase of labor to delivery | Measure of IL-8 in serum | week 37, week 38, week 39, week 40, week 41, week 42, upon admission for labor to OHSU | |
Primary | Changes in Basal body temperature during latent phase of labor to delivery | Measure body temperature first thing every morning until admission to hospital for birth. | Daily from 37 weeks gestation until admission to hospital for labor | |
Primary | Change in Maternal heart rate during latent phase of labor to delivery | Wearable sensor worn to record heart rate continually. | Continuously from 37 weeks gestation until admission to hospital for labor | |
Primary | Change in electrical activity of the uterus during latent phase of labor to delivery | Wearable sensor that records signals detected on the surface of the abdomen (e.g. signals generated by the uterus) and movements. | Continuously from 37 weeks gestation until admission to hospital for labor | |
Secondary | Characterize latent labor symptoms among nulliparous women in spontaneous labor | Quantify and characterize latent labor symptoms and identify relevant themes | week 37, week 38, week 39, week 40, week 41, week 42, upon admission for labor to OHSU | |
Secondary | Characterize trajectories of latent labor biomarkers across latent labor duration | Quantify subgroup phenotypes among nulliparous women in spontaneous latent labor | week 37, week 38, week 39, week 40, week 41, week 42, upon admission for labor to OHSU | |
Secondary | Characterize trajectories of latent labor symptoms across latent labor duration | Quantify subgroup phenotypes among nulliparous women in spontaneous latent labor using growth mixture modeling viewing longitudinal change. | week 37, week 38, week 39, week 40, week 41, week 42, upon admission for labor to OHSU |
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