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Trial registered on ANZCTR
Registration number
ACTRN12624000104550
Ethics application status
Approved
Date submitted
20/12/2023
Date registered
7/02/2024
Date last updated
7/02/2024
Date data sharing statement initially provided
7/02/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Encephalopathy in the Preterm Infant
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Scientific title
Incidence, Characterisation and Evolution of Encephalopathy in the Preterm Infant
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Secondary ID [1]
311079
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
Prem HI-5
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Prematurity
332224
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Encephalopathy
332225
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Brain development in the preterm infant
332335
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Brain injury in the preterm infant
332336
0
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Condition category
Condition code
Neurological
328940
328940
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0
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Other neurological disorders
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Neurological
328941
328941
0
0
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Studies of the normal brain and nervous system
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Reproductive Health and Childbirth
328942
328942
0
0
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Complications of newborn
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
This is an observational prospective cohort study that investigates babies born at less than 29 weeks’ gestation, including those infants with evidence of exposure to perinatal hypoxia-ischaemia. Data will be collected on antenatal history, birth and resuscitation details, progress, clinical examinations and investigations in the Neonatal Intensive Care Unit (NICU). For the study, participants will undergo additional periods of 1) brain monitoring including Near Infrared Spectroscopy (NIRS), electroencephalogram (EEG) and amplitude-integrated electroencephalogram (aEEG), and 2) brain imaging including cranial ultrasound (CrUSS) and Magnetic Resonance Imaging (MRI) of the brain. Video recordings will also be taken of routine neurological examinations at certain timepoints. Data will be collected from routine neurological and developmental assessments in the NICU including General Movements Assessment (GMA) and Hammersmith Neonatal Neurological Examination (HNNE).
Data will then be collected from the routine neurodevelopmental follow-up appointments at 12-14 weeks including GMA and Hammersmith Infant Neurological Examination (HINE) and 24-30 months corrected age (Bayley-4).
Outcomes of this exploratory prospective observational cohort study include:
1. Report the incidence of all cause encephalopathy, including contribution of perinatal hypoxia-ischaemia
2. Describe the pattern and evolution of encephalopathy in preterm infants
3. Describe the relationship between manifestations of encephalopathy and neurodevelopmental outcome at 12-14 weeks corrected age, and at 24-30 months corrected age.
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Intervention code [1]
327529
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Diagnosis / Prognosis
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Intervention code [2]
327608
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Early Detection / Screening
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Comparator / control treatment
No comparator/control.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Report the incidence of all cause encephalopathy, including contribution of perinatal hypoxia-ischaemia
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Assessment method [1]
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Incidence of encephalopathy is the primary outcome. Infants will be defined as having encephalopathy if they meet one or more of the following criteria:
- Abnormal neurological examination at one or more time points, OR
- Abnormal gestation specific amplitude integrated electroencephalogram (aEEG) OR
electroencephalogram (EEG) background pattern, OR
- Presence of electrographic seizures on aEEG or EEG
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Timepoint [1]
336737
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Term corrected age
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Secondary outcome [1]
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Describe the pattern and evolution of encephalopathy in preterm infants
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Assessment method [1]
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Incidence of encephalopathy (as defined above) at each study time point.
Descriptive statistics on infants with and without encephalopathy on pregnancy, birth, neonatal course, and study examination/investigation parameters.
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Timepoint [1]
429523
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Term corrected age
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Secondary outcome [2]
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Neurodevelopmental outcome at 12-14 weeks corrected age
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Assessment method [2]
429524
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GMA and HINE
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Timepoint [2]
429524
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12-14 weeks corrected age and
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Secondary outcome [3]
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Neurodevelopmental outcome at 24-30 months corrected age
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Assessment method [3]
430986
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Bayley-4
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Timepoint [3]
430986
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24-30 months corrected age
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Eligibility
Key inclusion criteria
- Infants less than 29 weeks’ gestational age at birth and admitted to the neonatal intensive care unit
- Less than or equal to 48 hours age at the time of recruitment
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Minimum age
0
Hours
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Maximum age
48
Hours
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Infants >29 weeks’ gestation at birth
- >48 hours age at the time of recruitment
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
19/02/2024
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Actual
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Date of last participant enrolment
Anticipated
22/02/2027
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Actual
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Date of last data collection
Anticipated
18/02/2030
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
25942
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Monash Medical Centre - Clayton campus - Clayton
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Recruitment hospital [2]
25943
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Monash Children’s Hospital - Clayton
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Recruitment postcode(s) [1]
41776
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3168 - Clayton
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Monash University
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Address [1]
315336
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Department of Paediatrics, 246 Clayton Road, Clayton, VIC, 3168
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Country [1]
315336
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Australia
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Primary sponsor type
Hospital
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Name
Monash Health
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Address
Monash Newborn, 246 Clayton Road, Clayton, VIC, 3168
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Country
Australia
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Secondary sponsor category [1]
317488
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University
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Name [1]
317488
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Monash University
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Address [1]
317488
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Department of Paediatrics, 246 Clayton Road, Clayton, VIC, 3168
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Country [1]
317488
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314259
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Monash Health Human Research Ethics Committee
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Ethics committee address [1]
314259
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Research Support Services, Monash Health Level 2, i Block, Monash Medical Centre, Clayton, VIC, 3168
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Ethics committee country [1]
314259
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Australia
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Date submitted for ethics approval [1]
314259
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21/09/2023
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Approval date [1]
314259
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06/10/2023
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Ethics approval number [1]
314259
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Summary
Brief summary
Prematurity remains common, and infants born prematurely have an increased risk of brain injury. “Encephalopathy of prematurity” refers to brain dysfunction and injury in preterm infants due to a variety of processes. It is known to be an important risk factor for adverse neurodevelopmental outcomes, however a thorough understanding of the causes, clinical presentation, evolution, and outcomes has not been fully established. The aim of this study is to better identify, understand and predict encephalopathy in preterm infants. This is an observational prospective cohort study that investigates babies born at less than 29 weeks’ gestation. Data will be collected on antenatal history, birth and resuscitation details, progress, clinical examinations and investigations in the Neonatal Intensive Care Unit (NICU). For the study, participants will undergo additional periods of brain monitoring and brain imaging. Video recordings will also be taken of routine neurological examinations at certain timepoints. Data will then be collected from routine developmental progress. Data will then be collected from the routine neurodevelopmental follow-up appointments at 12-14 weeks and 24-30 months corrected age. Outcomes of the study have the potential to improve the identification and care of infants at risk of encephalopathy, and better understand their prognosis. A better understanding of the condition may pave the way for future studies on targeted therapies to improve neonatal neurological and developmental outcomes.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Simone Huntingford
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Address
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Department of Paediatrics, Monash University, Level 5, 246 Clayton Road, Clayton, VIC, 3168
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Country
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Australia
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Phone
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+61 43 8572 3650
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Fax
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Email
130962
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[email protected]
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Contact person for public queries
Name
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Simone Huntingford
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Address
130963
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Department of Paediatrics, Monash University, Level 5, 246 Clayton Road, Clayton, VIC, 3168
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Country
130963
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Australia
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Phone
130963
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+61 43 8572 3650
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Fax
130963
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Email
130963
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[email protected]
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Contact person for scientific queries
Name
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Simone Huntingford
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Address
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Department of Paediatrics, Monash University, Level 5, 246 Clayton Road, Clayton, VIC, 3168
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Country
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Australia
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Phone
130964
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+61 43 8572 3650
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Fax
130964
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Email
130964
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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