Prematurity Clinical Trial
— AUBEOfficial title:
Assessment of Autonomic Maturation in Neonatal Period and Early Neural Development From a Longitudinal Prospective Cohort : the AuBE Study
The heart rate variability assessment of the sympathetic-parasympathetic balance is a strong
analytical tool in the autonomic nervous system (ANS) physiology, at each end of life.
In neonatology, it represents an important marker for understanding the breath and cardiac
dysfunction, incriminated in the pathophysiology of unexplained death syndrome and
apnea-bradycardia of prematurity.
If recent clinical studies conducted by our team highlight a close link between the
maturation degree of the ANS and gestational or postnatal age, with a substantial autonomic
dysfunction in preterm infants, no study to date has focused profile autonomic maturation in
the first two years of life, as that period for the infant is a vulnerability "window"
especially cardiopulmonary and neurological.
Psychomotor prognosis of newborns is more serious if prematurity is important and if
periventricular leukomalacia or cortical anatomical brain lesions are obvious. However, the
conventional imaging (Trans fontanel ultrasound, CT, MRI) is not sufficient in the neonatal
period to thoroughly evaluate the neurological risk situations. During the neonatal period,
the assessment of autonomic control, in practice easily quantifiable from time and
frequency-domain analysis of cardiac RR variability, could be a strong marker, at a given
time, from a neurological disorder undetectable by imaging, including sympathetic and
parasympathetic nerve conduction dysfunction in some brainstem nuclei and cortical areas.
The postnatal profile of the autonomic balance, as a marker of well ANS regulation could
become an additional support to correlate transient or permanent autonomic deficit with a
psychomotor development disorder at 2 years of age or later. This tool could be a help to
target the children with a neurological risk and to schedule early therapeutic interventions
and psychological or educational support.
Status | Completed |
Enrollment | 302 |
Est. completion date | July 2014 |
Est. primary completion date | July 2014 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Both |
Age group | N/A to 1 Week |
Eligibility |
Inclusion Criteria: - Every child born in the CHU of Saint-Étienne (inborn), any term of its birth, in the hospital neonatal unit at the time of registration (after 37 weeks corrected for prematurity) or in the maternity - Written consent signed by parents - Parents affiliated in a Social Security regimen Exclusion Criteria: - History of intrafamilial dysautonomia - Heart malformation, congenital abnormality of the brainstem - Permanent troubles of heart rate - Any therapy at the time of the study or made in the weeks preceding the study, referred to cardiac or respiratory or known to alter the activity of the ANS - General anesthesia within 2 weeks prior to registration |
Observational Model: Cohort, Time Perspective: Prospective
Country | Name | City | State |
---|---|---|---|
France | CHU de Saint-Etienne | Saint-etienne |
Lead Sponsor | Collaborator |
---|---|
Centre Hospitalier Universitaire de Saint Etienne | Ministry of Health, France |
France,
De Rogalski Landrot I, Roche F, Pichot V, Teyssier G, Gaspoz JM, Barthelemy JC, Patural H. Autonomic nervous system activity in premature and full-term infants from theoretical term to 7 years. Auton Neurosci. 2007 Oct 30;136(1-2):105-9. Epub 2007 Jun 7. — View Citation
Patural H, Pichot V, Jaziri F, Teyssier G, Gaspoz JM, Roche F, Barthelemy JC. Autonomic cardiac control of very preterm newborns: a prolonged dysfunction. Early Hum Dev. 2008 Oct;84(10):681-7. doi: 10.1016/j.earlhumdev.2008.04.010. Epub 2008 Jun 16. — View Citation
Patural H, Teyssier G, Pichot V, Barthelemy JC. [Normal and changed heart rate maturation of the neonate]. Arch Pediatr. 2008 Jun;15(5):614-6. doi: 10.1016/S0929-693X(08)71851-7. French. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Autonomic activity is represented by time-domain indices and frequency- domain indices, which reflect the short-term variability (parasympathetic branch) and medium term (ortho and parasympathetic branch) of the vegetative balance. | at birth and at 6, 12, 18 and 24 months | No | |
Secondary | the Bayley Scales of Infant Development, developmental with 4 areas of evaluation (motor or postural, oculomotor coordination, language, social relations) to calculate the global and partial quotient Development (QD). | At 24 months | No | |
Secondary | Specific criteria of pregnancy | at birth | No |
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