Status:
RECRUITING
Cord Clamping Among Neonates With Congenital Heart Disease
Lead Sponsor:
Carl Backes, MD
Collaborating Sponsors:
The George Washington University Biostatistics Center
National Heart, Lung, and Blood Institute (NHLBI)
Conditions:
Congenital Heart Disease (CHD)
Eligibility:
All Genders
37-42 years
Phase:
NA
Brief Summary
The goal of this clinical trial is to compare 2 different timepoints for clamping the umbilical cord at birth for term-born infants with a prenatal diagnosis of congenital heart disease (CHD). The mai...
Detailed Description
* AIM 1: Test the hypothesis that, among neonates with prenatally diagnosed significant CHD (ranking of 3 - 6 on the Fetal Cardiovascular Disease Severity Score \[FCDSS\]), DCC-120 results in lower gl...
Eligibility Criteria
Inclusion
- Inclusion criteria are listed below and will be confirmed prior to randomization:
- Fetal diagnosis of congenital heart disease (CHD) by prenatal ultrasound / echocardiography from local fetal ECHO, conducted on or after 18 weeks of gestation and prior to randomization. The study fetal diagnosis of CHD must be rated as 3 - 6 on the Fetal Cardiovascular Disease Severity Score (FCDSS), as determined by independent evaluators at the CORD-CHD trial ECHO Core at the Children's Hospital of Philadelphia (to determine final FCDSS eligibility for randomization).
- For each potential participant that has provided consent, the most relevant diagnostic prenatal ultrasound will be uploaded (shared) between 32 weeks of gestation and randomization for review by the ECHO Core. The ECHO Core will make the final FCDSS determination for eligibility status and stratification assignment.\]
- \[NOTE: A fetal diagnosis of CHD rated as 3 - 6 FCDSS per local review, including borderline cases, will be used to determine preliminary eligibility for consent. Among borderline cases, eligible patients will be included if there is a reasonable expectation of the need for surgery or cardiac catheterization during the birth hospitalization.\]
- Singleton gestation.
- Gestational age at randomization for impending deliveries between 37 0/7 - 41 6/7 weeks of gestation inclusive based on clinical information and evaluation of the earliest ultrasound determined using criteria proposed by the American Congress of Obstetricians and Gynecologists (ACOG), the American Institute of Ultrasound in Medicine and the Society for Maternal-Fetal Medicine.
- \[NOTE: Pregnant individuals who were admitted to the delivery hospital prior to 37 0/7 weeks of gestation remain eligible to randomize, provided they deliver within the 37 0/7 and 41 6/7 weeks "eligibility window". Alternatively, if an eligible dyad is randomized at or just prior to 41 6/7 weeks, they remain in trial.\]
- Consent for the participant and their infant
- Exclusion criteria are listed below and will be confirmed prior to randomization:
- Exclusion Criteria for Pregnant Individuals:
- Pregnant individual is a gestational carrier or surrogate.
- Compromise of the pregnant individual (e.g., vasa previa, placental accreta with hypotension, placental abruption, amniotic fluid embolism, uterine rupture, uterine inversion, disseminated intravascular coagulation), as determined by local care team
- \[NOTE: There is no limitation on pregnant individual's age\]
- Fetal Exclusion Criteria:
- Fetal demise or planned termination of pregnancy prior to randomization
- Tachyarrhythmia requiring transplacental therapy
- Fetal hydrops, severe
- Planned fetal surgery
- Diaphragmatic hernia, omphalocele, gastroschisis, intestinal atresia
- Major chromosomal defects (e.g., Trisomy 13, 18) identified prenatally; Trisomy 21 is allowed
- Disease or disorder impacting candidacy for neonatal cardiac interventions
- Parents choosing to limit treatment
- Pregnancy Exclusion Criteria:
- Delivery planned at an institution not affiliated with or does not refer to a CORD-CHD participating site
- Participation in another prenatal interventional study that influences cord clamping or perinatal morbidity or mortality
Exclusion
Key Trial Info
Start Date :
December 19 2023
Trial Type :
INTERVENTIONAL
Allocation :
ESTIMATED
End Date :
December 1 2030
Estimated Enrollment :
500 Patients enrolled
Trial Details
Trial ID
NCT06153459
Start Date
December 19 2023
End Date
December 1 2030
Last Update
August 5 2025
Active Locations (21)
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1
Children's of Alabama
Birmingham, Alabama, United States, 35233
2
Cedars-Sinai Medical Center
Los Angeles, California, United States, 90048
3
Children's Hospital of Orange County
Orange, California, United States, 92868
4
Lucile Packard Children's Hospital Stanford
Palo Alto, California, United States, 94304