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Trial registered on ANZCTR
Registration number
ACTRN12622001450707
Ethics application status
Approved
Date submitted
4/10/2022
Date registered
14/11/2022
Date last updated
14/11/2022
Date data sharing statement initially provided
14/11/2022
Type of registration
Retrospectively registered
Titles & IDs
Public title
Investigating the use of biomarkers to predict pregnancy and long term complications in women who develop elevated blood pressure, gestational diabetes, fetal growth restriction or spontaneous preterm labour during pregnancy
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Scientific title
Investigating the use of biomarkers to predict pregnancy and long term cardiovascular complications in women who develop elevated blood pressure, gestational diabetes, fetal growth restriction or spontaneous preterm labour during pregnancy
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Secondary ID [1]
307916
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
BIOPIC
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
pre-eclampsia
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Gestational Diabetes
327563
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Spontaneous preterm birth
327564
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Fetal growth restriction
327565
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Condition category
Condition code
Reproductive Health and Childbirth
324653
324653
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0
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Antenatal care
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Reproductive Health and Childbirth
325065
325065
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0
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Fetal medicine and complications of pregnancy
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Reproductive Health and Childbirth
325233
325233
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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
This observational study does not include any intervention to routine medical care of the participant.
Participation will involve completion of a questionnaire and collection of 3 blood samples.
The questionnaire will have questions regarding basic demographic information, past medical history, details of previous pregnancy/pregnancies (gestational age at delivery, complications during pregnancy, any antenatal interventions, mode of delivery and birth weight), as well as details of current pregnancy (pregnancy complications, antenatal interventions). This will take 10-15min to complete.
Blood samples will be collected once at time of recruitment, once at development of complications or at 36 weeks gestations, and finally at 6 months post birth.
For this study we will also be collecting de-identified data from participant's medical records. This include demographic details, past medical history, antenatal complications, antenatal interventions, mode of delivery and any peri-partum complications.
The total observational period will be from time of recruitment (at any gestation of pregnancy) until 6 months post delivery.
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Intervention code [1]
324546
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Diagnosis / Prognosis
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Comparator / control treatment
The comparator will be participants who are recruited after meeting eligibility criteria (blood pressure >130/80) who have not developed and does not go on to develop any pregnancy complications (hypertension in pregnancy, gestational diabetes, fetal growth restriction, spontaneous preterm birth).
For this group, blood samples will be collected at time of recruitment and at 36 weeks gestation.
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Control group
Active
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Outcomes
Primary outcome [1]
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Women with demographic or examination (e.g. elevated BP >=130/80) risk factors who go on to develop pre-eclampsia by current diagnostic criteria of pre-eclampsia (blood pressure >140/90 with evidence of end organ dysfunction).
This will be determined by review of medical records and pathology results. As well as by patient self reporting.
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Assessment method [1]
332678
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Timepoint [1]
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This outcome will be determined through weekly review of participant's medical record from time of recruitment until birth to identify the development of pre-eclampsia. Or at any time during this period by patient self report.
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Primary outcome [2]
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Women with pregnancy complications (Gestational diabetes, hypertensive disorder of pregnancy, fetal growth restriction and spontaneous preterm birth) who have persistent derangement in cardio-metabolic markers (HbA1c, Insulin levels, BNP, Lipid profile) 6-12 months post-partum. This will be assessed using blood samples.
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Assessment method [2]
332893
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Timepoint [2]
332893
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This outcome will be assessed through blood samples which will be collected once at time of recruitment, once at development of complications or at 36 weeks gestations, and once at 6-12 months post-partum at the convenience of the participant.
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Primary outcome [3]
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Women with elevated blood pressures (>130/80) and/or pregnancy complications (Gestational diabetes, hypertensive disorder of pregnancy, fetal growth restriction and spontaneous preterm birth) who have derangement in placental markers (sFlt, PLGF, sFlt/PLGF ratio), assessed using blood samples.
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Assessment method [3]
333079
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Timepoint [3]
333079
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his outcome will be assessed through blood samples which will be collected once at time of recruitment, once at development of complications or at 36 weeks gestations, and once at 6-12 months post-partum at the convenience of the participant.
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Secondary outcome [1]
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Adverse maternal outcomes: This will include a composite of hepatic dysfunction, acute renal insufficiency, placental abruption, acute pulmonary oedema, development of HELLP (Haemolysis, elevated liver enzymes, low platelets) syndrome, need for parenteral antihypertensive medication, need for insulin therapy, admission to intensive care unit, mode of delivery and postpartum haemorrhage.
These outcomes will be assessed by review of participant medical records.
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Assessment method [1]
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Timepoint [1]
414340
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This outcome will be determined through review of participant's medical record from the time of enrolment to the time of delivery.
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Secondary outcome [2]
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Adverse perinatal outcomes: This will include a composite of gestation at delivery, birth weight, stillbirth, neonatal death and neonatal morbidity. Neonatal morbidity will be defined as admission to a neonatal special care nursery or intensive care unit for more than 48 hours, respiratory distress syndrome, need for mechanical ventilation, intraventricular haemorrhage, confirmed infection, necrotising enterocolitis, seizures, encephalopathy and retinopathy of prematurity.
Incidence of these perinatal outcomes will be assessed through review of the of participant's newborn's medical records.
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Assessment method [2]
415001
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Timepoint [2]
415001
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This outcome will be determined through review of participant's baby's medical record from time of delivery to 28 days after birth.
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Secondary outcome [3]
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Women with elevated blood pressures (>130/80) and/or pregnancy complications (Gestational diabetes, hypertensive disorder of pregnancy, fetal growth restriction and spontaneous preterm birth) who have derangement in endothelial dysfunction markers (ICAM 1, VCAM 1, tumor necrosis factor-alpha) assessed using blood samples
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Assessment method [3]
415721
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Timepoint [3]
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This outcome will be assessed through blood samples which will be collected once at time of recruitment, once at development of complications or at 36 weeks gestations, and once at 6-12 months post-partum at the convenience of the participant.
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Eligibility
Key inclusion criteria
1. Pregnant women at any gestation in pregnancy AND
2. Women who develop elevated blood pressure >130/80 OR
3. Women who have developed pregnancy complications (Gestational diabetes (GDM), Hypertensive disorder of pregnancy (HDP), Fetal growth restriction(FGR) and spontaneous preterm birth(sPTB))
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Minimum age
18
Years
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Maximum age
55
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Multiple pregnancy.
2. Pregnancy complicated by major fetal anomaly or genetic syndrome.
3. Maternal age less than 18 years,
4. Women incapable of giving valid consent (diminished understanding, non-English speaking
and interpreter unavailable).
5. Participation in a study where there is a pharmaceutical intervention that would likely modify the biomarkers under study.
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Study design
Purpose
Screening
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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
For comparison between groups, t-test and/or Mann-Whitney test and binary logistic regression will be used, as appropriate. To test and adjust for potential confounders, logistic regression analysis will be performed. Screening performance will be assessed using sensitivity, specificity, positive and negative predictive values and Receiver Operating Curve (ROC) areas. The analysis will be carried out using SPSS 16.0 (SPSS Inc., Chicago, IL) and Stata (version 12 or later; StataCorp, College Station, Texas, USA). The study will be reported in accordance with STAndards for the Reporting of Diagnostic accuracy studies (STARD) guidelines.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
3/10/2022
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Date of last participant enrolment
Anticipated
3/10/2024
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Actual
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Date of last data collection
Anticipated
31/12/2025
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Actual
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Sample size
Target
600
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Accrual to date
1
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Dandenong Hospital- Monash Health - Dandenong
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Recruitment hospital [2]
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Monash Medical Centre - Clayton campus - Clayton
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Recruitment hospital [3]
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Casey Hospital - Berwick
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Recruitment postcode(s) [1]
38652
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3175 - Dandenong
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Recruitment postcode(s) [2]
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3168 - Clayton
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Recruitment postcode(s) [3]
38654
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3806 - Berwick
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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]
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Wellington road, Clayton, VIC 3800
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Country [1]
312189
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Australia
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Primary sponsor type
Charities/Societies/Foundations
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Name
National Heart Foundation
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Address
2/850 Collins St, Melbourne VIC 3008
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Country
Australia
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Secondary sponsor category [1]
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Government body
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Name [1]
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NHMRC
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Address [1]
313718
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414 La Trobe St, Melbourne VIC 3000
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Country [1]
313718
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
311576
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Monash Health HREC
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Ethics committee address [1]
311576
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Level 2, I Block Monash Medical Centre 246 Clayton Road Clayton Victoria 3168
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Ethics committee country [1]
311576
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Australia
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Date submitted for ethics approval [1]
311576
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06/04/2022
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Approval date [1]
311576
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09/08/2022
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Ethics approval number [1]
311576
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RES-22-0000-197A
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Summary
Brief summary
Purpose of study: In Australia, up to 1 in 20 women will have a pregnancy impacted by pre-eclampsia, however recent changes to the definition of high blood pressure may assist in finding women most at risk earlier in their pregnancy. This study will explore a new approach to diagnosing pre-eclampsia that could benefit women in the future. Similarly, a third of women are affected by cardio-metabolic conditions during pregnancy such as gestational diabetes (GDM), pregnancy induced hypertension, pre-eclampsia, fetal growth restriction and spontaneous preterm birth. These conditions not only cause significant morbidity during pregnancy but are also associated with increased risk of maternal Type 2 Diabetes and Cardiovascular Disease (CVD) after pregnancy. However, CVD risk prediction tools do not capture these pregnancy-related cardio-metabolic conditions. Younger women and their health professionals have a limited understanding of the risks and screening and prevention are generally lacking. We know that these risks can be reduced by preventative screening (such as early screening for diabetes, abnormal lipid levels or elevated blood pressure) and optimising lifestyle strategies. This study offers an important opportunity to identify and target these women at risk for early intervention and screening. Hypothesis: Biological markers of endothelial, placental, inflammatory and cardiac dysfunction can be used to create an algorithm that can better predict the risk of developing pre-eclampsia, as well as risk of long-term cardiovascular sequelae in patients affected by pregnancy complications. Evidenced by derangement in cardio-metabolic markers following development of these conditions which persists post-delivery. Study design: Prospective observational trial involving two blood collection during pregnancy as well as after delivery. Where possible these blood test would be performed at time of routine pathology collection. Blood test result of patient who develops complication and those who does not is compared to develop an algorithm for prediction and diagnosis of pregnancy complications, as well as evaluate risk of long term cardiovascular complications. This study is observational only and does not interfere with routine antenatal care.
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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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A/Prof Kirsten Palmer
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Address
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Monash University
246 Clayton Road, Clayton VIC 3168
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Country
121582
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Australia
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Phone
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+61419846049
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Fax
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Email
121582
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[email protected]
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Contact person for public queries
Name
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Amy Liu
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Address
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Monash University
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 395946666
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Fax
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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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Amy Liu
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Address
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Monash University
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 395946666
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Fax
121584
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Email
121584
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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.
Download to PDF