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Trial registered on ANZCTR
Registration number
ACTRN12612000282886
Ethics application status
Approved
Date submitted
28/02/2012
Date registered
9/03/2012
Date last updated
30/10/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Fetal cardiovascular response to maternal corticosteroid administration: a comparison of dexamethasone versus betamethasone
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Scientific title
Fetal cardiovascular response to maternal corticosteroid administration for fetal lung maturity: an observational comparison of dexamethasone versus betamethasone ultrasound and cardiotocograph effects within the A*STEROID randomised controlled trial
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Secondary ID [1]
280048
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Nil
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Universal Trial Number (UTN)
U1111-1128-6330
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Trial acronym
SUPER-A*STEROID
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Fetal cardiovascular status, and its correlation with neonatal outcome and long-term childhood neurosensory disability, following antenatal corticosteroids given to women at risk of preterm birth at less than 34 weeks gestation
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Condition category
Condition code
Reproductive Health and Childbirth
286147
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0
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Fetal medicine and complications of pregnancy
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Intervention/exposure
Study type
Observational
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Patient registry
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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
Dexamethasone (antenatal corticosteroid) - 2 syringes of 12 mg dexamethasone (dexamethasone sodium phosphate - a non-sulphite containing preparation) administered as 2 intramuscular injections, 24 hours apart. (Performed as part of parent A*STEROID trial, ACTRN 12608000631303 - drugs not administered by this trial's investigators)
Observational component: Fetal cardiovascular and behavioural effects of corticosteroids (as measured by ultrasound and cardiotocograph) in the first week after maternal corticosteroid administration. Correlation with neonatal and early childhood outcome.
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Intervention code [1]
284372
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Not applicable
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Comparator / control treatment
Betamethasone (antenatal corticosteroid) - 2 syringes of 11.4 mg betamethasone (as Celestone Chronodose 11.4 mg) administered as 2 intramuscular injections, 24 hours apart. (Performed as part of parent A*STEROID trial, ACTRN 12608000631303 - drugs not administered by this trial's investigators)
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Control group
Active
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Outcomes
Primary outcome [1]
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Fetal middle cerebral artery pulsatility index measurement as measured by Doppler ultrasound.
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Assessment method [1]
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Timepoint [1]
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Baseline (prior to corticosteroid administration), 24 hours (range 18-30 hours), 48 hours (range 42-54 hours), 96 hours (range 3-5 days), 7 days (range 7-10 days, prior to any repeat dose corticosteroid).
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Primary outcome [2]
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Fetal heart rate short term-variability on cardiotocograph.
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Assessment method [2]
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Timepoint [2]
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Baseline (prior to corticosteroid administration), 24 hours (range 18-30 hours), 48 hours (range 42-54 hours), 96 hours (range 3-5 days), 7 days (range 7-10 days, prior to any repeat dose corticosteroid).
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Secondary outcome [1]
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Fetal umbilical artery pulsatility index measurement as measured by Doppler ultrasound.
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Assessment method [1]
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Timepoint [1]
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Baseline (prior to corticosteroid administration), 24 hours (range 18-30 hours), 48 hours (range 42-54 hours), 96 hours (range 3-5 days), 7 days (range 7-10 days, prior to any repeat dose corticosteroid).
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Secondary outcome [2]
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Fetal umbilical artery resistive index measurement as measured by Doppler ultrasound.
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Assessment method [2]
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Timepoint [2]
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Baseline (prior to corticosteroid administration), 24 hours (range 18-30 hours), 48 hours (range 42-54 hours), 96 hours (range 3-5 days), 7 days (range 7-10 days, prior to any repeat dose corticosteroid).
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Secondary outcome [3]
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Fetal myocardial performance index measurement as measured by Doppler ultrasound.
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Assessment method [3]
296282
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Timepoint [3]
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Baseline (prior to corticosteroid administration), 24 hours (range 18-30 hours), 48 hours (range 42-54 hours), 96 hours (range 3-5 days), 7 days (range 7-10 days, prior to any repeat dose corticosteroid).
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Secondary outcome [4]
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Fetal middle cerebral artery peak systolic volume measurement as measured by Doppler ultrasound.
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Assessment method [4]
296283
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Timepoint [4]
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Baseline (prior to corticosteroid administration), 24 hours (range 18-30 hours), 48 hours (range 42-54 hours), 96 hours (range 3-5 days), 7 days (range 7-10 days, prior to any repeat dose corticosteroid).
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Secondary outcome [5]
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Maternal uterine artery pulsatility index measurement as measured by Doppler ultrasound.
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Assessment method [5]
296284
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Timepoint [5]
296284
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Baseline (prior to corticosteroid administration), 24 hours (range 18-30 hours), 48 hours (range 42-54 hours), 96 hours (range 3-5 days), 7 days (range 7-10 days, prior to any repeat dose corticosteroid).
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Secondary outcome [6]
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Fetal ductus venosus waveform measurement as measured by Doppler ultrasound.
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Assessment method [6]
296285
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Timepoint [6]
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Baseline (prior to corticosteroid administration), 24 hours (range 18-30 hours), 48 hours (range 42-54 hours), 96 hours (range 3-5 days), 7 days (range 7-10 days, prior to any repeat dose corticosteroid).
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Secondary outcome [7]
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Fetal biophysical profile score (standardised ultrasound measure).
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Assessment method [7]
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Timepoint [7]
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Baseline (prior to corticosteroid administration), 24 hours (range 18-30 hours), 48 hours (range 42-54 hours), 96 hours (range 3-5 days), 7 days (range 7-10 days, prior to any repeat dose corticosteroid).
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Secondary outcome [8]
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Umbilical arterial cord pH <7.20
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Assessment method [8]
296287
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Timepoint [8]
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As measured after birth
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Secondary outcome [9]
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Placental weight >90th centile for gestation
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Assessment method [9]
296288
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Timepoint [9]
296288
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As measured after birth
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Secondary outcome [10]
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Neonatal outcomes including intraventricular haemorrahge (IVH), severe intraventricular haemorrhage (IVH), periventricular leukomalacia (PVL), retinopathy of prematurity needing treatment, patent ductus arteriosus needing treatment, use of inotropes, respiratory distress syndrome, severity of any neonatal lung disease, chronic lung disease (need for oxygen at 36 weeks post-menstrual age), use of mechanical ventilation, confirmed infection within the first 48 hours, infection after the first 48 hours, body size at birth (weight, length and head circumference) and at discharge home after birth
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Assessment method [10]
296289
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Timepoint [10]
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At hospital discharge
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Secondary outcome [11]
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Composite of incidence of death (defined as stillbirths, deaths from live born infants before hospital discharge and deaths after hospital discharge) or any neurosensory disability in the children (includes the neurosensory impairments of cerebral palsy, blindness, deafness and any developmental delay defined as a standardised score more than 1 SD below the mean (<-1SD)).
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Assessment method [11]
296290
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Timepoint [11]
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At 2 years corrected age
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Eligibility
Key inclusion criteria
Women are eligible for the trial if they are at risk of preterm birth at less than 34 weeks gestation, are aged 18-50, have a singleton or twin pregnancy, have no contraindications to the use of antenatal corticosteroids and give informed consent to both the A*STEROID trial and this trial.
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Minimum age
18
Years
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Maximum age
50
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Women are not eligible if they have chorioamnionitis requiring urgent delivery, a higher order multiple pregnancy, have already received antenatal corticosteroids, have known fetal lung maturation, are in the second stage of labour, have an abnormal morphology scan, are taking digoxin or pure beta-blocker, have psychiatric illness precluding informed consent, or have insufficient English for valid consent.
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/03/2012
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Actual
23/02/2012
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Date of last participant enrolment
Anticipated
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Actual
31/01/2013
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
50
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Accrual to date
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Final
43
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Royal Hospital for Women - Randwick
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Recruitment hospital [2]
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St George Hospital - Kogarah
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Recruitment postcode(s) [1]
5031
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2031
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Recruitment postcode(s) [2]
5032
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2217
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Australasian Society of Ultrasound in Medicine
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Address [1]
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PO Box 943,
Crows Nest NSW 1585
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Dr Amanda Henry
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Address
School of Women's and Children's Health
University of New South Wales
Level 1, Royal Hospital for Women,
Randwick
NSW 2031
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Professor Alec Welsh
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Address [1]
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Professor of Maternal-Fetal Medicine
School of Women's and Children's Health
University of New South Wales
Level 1, Royal Hospital for Women,
Randwick
NSW 2031
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Country [1]
283683
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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South Eastern Sydney Local Health District HREC - Northern Sector
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Ethics committee address [1]
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Room G71 East Wing Edmund Blackett Building Prince of Wales Hospital Randwick NSW 2031
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
286789
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Approval date [1]
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23/01/2012
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Ethics approval number [1]
286789
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1/11/0202
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Summary
Brief summary
The primary aims of the trial are (within the context of the RCT A*STEROID) 1) To evaluate the effects of betamethasone and dexamethasone on fetal cardiovascular status as assessed by the ultrasound parameters of umbilical artery Doppler, middle cerebral artery Doppler, ductus venosus Doppler, uterine artery Doppler, and myocardial performance index. 2) To evaluate the effects of betamethasone and dexamethasone on fetal cardiovascular status as assessed by computerized cardiotocograph (cCTG) using Dawes-Redman criteria. 3) To evaluate the effects of betamethasone and dexamethasone on placental weight, morphology and histological evidence of villous maturation postpartum, and correlate this with placental ultrasound and uterine artery Doppler findings.
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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 Amanda Henry
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Address
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School of Women's and Children's Health, UNSW
Level 1, Royal Hospital for Women
Barker St (Locked Bag 2000),
Randwick, NSW 2031
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Country
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Australia
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Phone
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+61 2 91132315
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Amanda Henry
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Address
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School of Women's and Children's Health
University of New South Wales
Level 1, Royal Hospital for Women
Randwick NSW 2031
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Country
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Australia
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Phone
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+61 2 91132315
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Fax
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+61 2 9382 6444
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Amanda Henry
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Address
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School of Women's and Children's Health
University of New South Wales
Level 1, Royal Hospital for Women
Randwick NSW 2031
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Country
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Australia
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Phone
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+61 2 91132315
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Fax
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+61 2 9382 6444
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Email
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[email protected]
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No information has been provided regarding IPD availability
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.
Download to PDF