Preterm Birth Clinical Trial
Official title:
The GROWNDUP Study: Pilot to Assess the Feasibility of an RCT for Promoting Growth, Nutrition and Development Through a Specialized Late Preterm Clinic
This pilot study will examine the feasibility of conducting a large randomized clinical
trial (RCT) to examine the role of a novel, specialized follow-up clinic in preventing
complications among late preterm infants (LPTB), born between 34 and 36 weeks gestational
age. 1) Study Process: Success will be achieved if 80% of a target population of 100
subjects is met within the first 6 months of recruitment being initiated. 2) Study
Resources: Success will be achieved if 80% of follow up appointments are scheduled in a
timely manner and if specialized LPTB physicians in the intervention complete assessments
75% of the time in the allocated time frame and 3) Scientific: 95% data completeness on data
collection forms will be identified as success
A specialized LPTB follow-up clinic is innovative as no studies have evaluated such a
programme and standardized follow-up and guidelines for the care of LPTB infants after
discharge from hospital do not exist. Until recently, the incorrect assumption has been that
these infants are healthy and have limited risks compared to term infants.
The study's main question, in addition to assessing the feasibility of this pilot, is: "Do
differences exist in short-tem clinical and developmental outcomes among LPTB infants
enrolled in an RCT who are randomized to a specialized LPTB follow-up programme when
compared to infants randomized to current pragmatic management?" A RCT will provide evidence
for the development of guidelines for the follow-up of LPTB infants in the first 6 months of
life to reduce complications, readmissions and developmental problems.
The results of this study can be generalized to tertiary care and community hospitals and
the general population.
Late preterm births comprise 70-75% of all preterm births in Ontario and 5.8% of all births
in the province. These infants are at significant risk for complications but no guidelines
or follow-up programmes exist for decreasing the short and long-term complications
associated with LPTB. This project will lay the groundwork for gathering the research
evidence to support:
1. An RCT that will study if a specialized LPTB clinic is effective in reducing short-term
medical and developmental complications and hospital readmissions,
2. Development of a sustainable long-term follow-up programme supported by evidence,
3. Development of a database to track long-term complications, with the goal of
identifying potential risk factors earlier in late preterm infants,
4. Creation and dissemination of Evidence-Based Guidelines, research results for frontline
health care providers (GPs, Midwives, etc.), community hospitals and Local Health
Integration Networks,
5. Creation and dissemination of Parent Educational Resources for discharge of LPTB
infants.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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