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Trial registered on ANZCTR
Registration number
ACTRN12618000871246
Ethics application status
Approved
Date submitted
11/05/2018
Date registered
22/05/2018
Date last updated
10/05/2021
Date data sharing statement initially provided
23/08/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Understanding Creatine for Neurological Health in Babies
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Scientific title
Circulating and Cerebral Creatine Levels of the Preterm Infant: Implications for Neurological Development.
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Secondary ID [1]
294860
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None
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Universal Trial Number (UTN)
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Trial acronym
UNICORN Babies
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Preterm Birth
307810
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Condition category
Condition code
Neurological
306858
306858
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0
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Other neurological disorders
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Diet and Nutrition
306859
306859
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0
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Other diet and nutrition disorders
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Reproductive Health and Childbirth
306871
306871
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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
Observations [1] Measurement of creatine and associated metabolites in plasma, urine and nutrition samples, collected from preterm babies across the duration of their stay within the NICU; [2] MRI/MRS scan at term equivalent age; [3] Developmental follow up assessment at three months term corrected age.
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Intervention code [1]
301170
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Diagnosis / Prognosis
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Intervention code [2]
301171
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Early Detection / Screening
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Comparator / control treatment
healthy singleton babies born at term (39-40 weeks gestation)
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Control group
Active
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Outcomes
Primary outcome [1]
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Infant creatine levels (composite outcome of plasma, urinary and cerebral measures) at term corrected age. Plasma and urine creatine will be measured using LC-MS, and cerebral creatine measured from an MRI/MRS scan.
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Assessment method [1]
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Timepoint [1]
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Term corrected age
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Secondary outcome [1]
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Creatine content of diet (TPN, formula or breastmilk) received by infants during their stay in hospital, measured using LC-MS.
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Assessment method [1]
346773
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Timepoint [1]
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term corrected age.
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Secondary outcome [2]
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Neurological outcomes of infants up to 3 month of age. Composite measures of MRI scans, general movements assessment and the DAYC-2 developmental assessment tool.
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Assessment method [2]
346823
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Timepoint [2]
346823
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Term corrected age and 3 months of term corrected age.
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Eligibility
Key inclusion criteria
1. Singleton babies
2. Provision of Signed and Dated Informed Consent from Parent/Guardian
3. Preterm infants of gestational post maternal age receiving care within the Neonatal Intensive Care Unit at CCDHB, or, healthy term infants at 39-40 weeks gestation from low risk pregnancies delivered at CCDHB.
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Minimum age
23
Weeks
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Maximum age
40
Weeks
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
1. Babies with major congenital, genetic or chromosomal abnormalities known to affect neurodevelopmental outcomes
2. Hypoxic ischaemic encephalopathy
3. Inborn (proven or suspected) errors of metabolism
4. Fetal growth restriction (birth weight <10th percentile on customised percentiles)
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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
Recruiting
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Date of first participant enrolment
Anticipated
28/05/2018
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Actual
13/08/2018
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
31/08/2021
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Actual
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Sample size
Target
100
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Accrual to date
82
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Final
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Recruitment outside Australia
Country [1]
10394
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New Zealand
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State/province [1]
10394
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Wellington
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Funding & Sponsors
Funding source category [1]
299449
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Charities/Societies/Foundations
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Name [1]
299449
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Cerebral Palsy Alliance
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Address [1]
299449
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187 Allambie Rd, Allambie Heights, NSW 2100
PO Box 6427, Frenchs Forest, NSW 2086
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Country [1]
299449
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Australia
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Primary sponsor type
University
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Name
Hudson Institute of Medical Research/Monash University
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Address
27-31 Wright Street, Clayton, Victoria 3168
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
298745
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Address [1]
298745
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Country [1]
298745
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
300355
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Central Health and Disability Ethics Committee
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Ethics committee address [1]
300355
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Ministry of Health
Health and Disability Ethics Committees
PO Box 5013
Wellington 6140
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Ethics committee country [1]
300355
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New Zealand
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Date submitted for ethics approval [1]
300355
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11/01/2018
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Approval date [1]
300355
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26/04/2018
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Ethics approval number [1]
300355
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18/CEN/17
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Summary
Brief summary
Each year around 10% of all babies born in Australia and New Zealand are preterm. Over half of these babies will have acquired brain injury, increasing their risks of developing life-long conditions, such as cerebral palsy. Creatine and its phosphorylated derivative phosphocreatine (PCr) have long been established as having a critical role in neural development and brain metabolism, with creatine deficiency syndromes leading to significant neurological impairments, including mental retardation, expressive speech and language delay, autistic like behaviour and epilepsy. We have evidence from preclinical animal studies to suggest that preterm babies will be creatine deficient due to an immature renal-hepatic axis and inability to make creatine. Our preliminary data from a 26-week preterm infant shows a dramatic fall in plasma creatine concentration over the first week of life, suggesting this baby was unable to maintain creatine homeostasis. These observations taken together raise questions about whether creatine insufficiency predisposes or compounds neurological deficits in preterm infants?
We will utilise non-invasive imaging techniques to measure cerebral creatine levels in preterm infants, to determine any creatine deficiencies in this population. The innovation of this work is that early detection of cerebral creatine deficiency in preterm infants will provide the basis of early intervention with creatine supplementation to avoid cerebral energy deficiency and the ensuing development of poor neurological sequela associated with these deficiencies. If our hypothesis is proven, we stand to revolutinise the nutritional care of preterm infants, directly influence brain function and improve the short and long-term neurological outcomes for these babies.
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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 Max Berry
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Address
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Department of Paediatrics and Child Health, University of Otago Wellington
23A Mein Street
Wellington, New Zealand 6242
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Country
83378
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New Zealand
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Phone
83378
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+64 212449929
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Fax
83378
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Email
83378
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[email protected]
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Contact person for public queries
Name
83379
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Dr Max Berry
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Address
83379
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Department of Paediatrics and Child Health, University of Otago Wellington
23A Mein Street
Wellington, New Zealand 6242
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Country
83379
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New Zealand
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Phone
83379
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+64 212449929
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Fax
83379
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Email
83379
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[email protected]
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Contact person for scientific queries
Name
83380
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Dr Stacey Ellery
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Address
83380
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Hudson Institute of Medical Research
27-31 Wright Street, Clayton, Victoria 3168
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Country
83380
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Australia
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Phone
83380
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+61 385722870
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Fax
83380
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Email
83380
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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
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
4200
Study protocol
Berry, Mary J., et al. "UNICORN Babies: Understanding Circulating and Cerebral Creatine Levels of the Preterm Infant. An Observational Study Protocol." Frontiers in physiology 10 (2019).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417365/
375080-(Uploaded-20-08-2019-16-25-20)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Unicorn babies: Understanding circulating and cerebral creatine levels of the preterm infant. An observational study protocol.
2019
https://dx.doi.org/10.3389/fphys.2019.00142
N.B. These documents automatically identified may not have been verified by the study sponsor.
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