Retinopathy of Prematurity

Preterm birth, defined as birth before 37 weeks of gestation, occurs in about 8 percent of pregnancies in Canada and is linked to many health challenges, especially when it happens before 29 weeks. At this early stage, infants often face breathing difficulties and may require resuscitation. This trial compares resuscitation using either low (30%) or high (60%) oxygen levels to determine which approach results in better survival and neurodevelopmental outcomes at around 24 months of age. The study uses a cluster randomized crossover design where hospitals alternate between starting resuscitation with 30% or 60% oxygen for groups of 30 infants. Resuscitation includes standard care steps like lung expansion and ventilation support as needed. Oxygen is initially given at the assigned concentration for the first 5 minutes, then adjusted based on the infant's oxygen saturation levels and heart rate over the next 5 minutes to maintain target saturation ranges. This approach aims to balance risks of too much or too little oxygen. Participants are infants born between 23 and 28 weeks gestation who receive full resuscitation at participating centers. During the study, infants have oxygen saturation monitored continuously, and adjustments to oxygen concentration are made carefully. Researchers will evaluate survival and major neurodevelopmental outcomes at 24 months corrected age, along with several safety and health measures during the neonatal intensive care stay. The trial is expected to provide important evidence to guide oxygen use during resuscitation of extremely preterm infants.

Researchers are evaluating an investigational drug called OHB-607 to prevent Bronchopulmonary Dysplasia (BPD), a common chronic lung disease in extremely premature infants. The study compares infants receiving OHB-607 to those receiving standard neonatal care to see if the drug can reduce the incidence of severe BPD or death by 36 weeks postmenstrual age. This is a Phase 2b, randomized, open-label study involving infants born between 23 weeks 0 days and 27 weeks 6 days gestational age. Participants in the trial will be randomly assigned to one of two groups. One group will receive a continuous intravenous infusion of OHB-607 from birth until 29 weeks and 6 days postmenstrual age. The other group will receive standard neonatal care without the investigational drug. This approach allows researchers to compare the effects of OHB-607 against routine care practices for preventing lung disease in these infants. During the study, infants will be closely monitored through 36 weeks postmenstrual age and up to 24 months corrected age. Researchers will assess lung health, including the incidence and severity of BPD, time to weaning off respiratory support, and other complications such as intraventricular hemorrhage and retinopathy of prematurity. Developmental outcomes will also be measured using standardized scales at 24 months corrected age. Safety assessments and long-term follow-up are included to understand the drug's effects over time.

Researchers are conducting a nationwide, multicenter observational study in China to investigate the severity and challenges faced by Small Vulnerable Newborns (SVN), including preterm, small for gestational age, and low birth weight infants. The study aims to provide a clear and unified description of these newborns' issues and to develop targeted prevention strategies to improve care and outcomes. This comprehensive research gathers data across multiple centers to better understand the scope of these conditions. In this study, participating hospitals across China will collect clinical data on vulnerable newborns under their care throughout 2024. Detailed questionnaires will be completed to support thorough data collection. The study does not involve any treatment interventions; instead, it focuses on observation and data gathering to assess the incidence, complications, and mortality rates of these newborns. Participants in the study will have their clinical information recorded from hospital admission until discharge or death, with follow-up up to one year. Researchers will measure the number of small vulnerable newborns, their mortality rates, and the incidence of related complications. This observational approach aims to provide valuable insights to guide prevention efforts and improve care for these at-risk infants.

Researchers are investigating the use of bubble continuous positive airway pressure (bCPAP) in preterm infants born before 32 weeks gestation. This observational, proof-of-concept study aims to understand how the sounds produced by the bubbling in the bCPAP device relate to the airway pressures delivered to the infant's lungs. The goal is to develop models that predict these pressures from the acoustic properties of the bubbling sounds, potentially offering a new way to monitor therapy effectiveness in real time. The study involves two groups of 15 preterm infants each, all receiving bCPAP treatment in the neonatal intensive care unit. Group 1 will have their external bubble sounds and CPAP system pressures recorded using a microphone on the water tank and a pressure transducer in the expiratory limb for 3 hours. Group 2 will have similar measurements plus internal sounds and pressures recorded via a wireless sensor placed on the infant's suprasternal notch and an internal pressure transducer inserted into the nasopharynx, also for 3 hours. During the study, participants will be monitored for 3 hours with continuous recording of pressures and acoustic data. Researchers will assess external and internal bubble sounds alongside airway pressures. Data collection uses specialized devices to capture and store sound and pressure information for later analysis. The study helps evaluate the relationship between acoustic signals and pressure delivery in preterm infants on bCPAP, with the entire study expected to run until December 2026.

This research aims to evaluate a new advanced wireless skin sensor system designed to monitor vital signs in healthy newborn infants of at least 35 weeks gestational age. The study focuses on assessing the feasibility, safety, and accuracy of this wireless system compared to the standard wired monitoring during the first two hours after birth, especially during unsupervised parental care in the obstetrical center. The goal is to improve early detection and prevention of Sudden Unexpected Postnatal Collapse (SUPC), a rare but serious condition affecting newborns shortly after delivery. Participants will have both the wireless monitoring system and the standard wired system placed on their chest and limb. For vaginal births, the wireless system is placed first, followed by the wired system after 15-20 minutes; for C-section births, the order of placement is randomized. Both monitoring systems remain in place for two hours to continuously record vital signs such as heart rate, respiratory rate, oxygen saturation, and skin temperature. During the study, newborns' vital signs will be recorded and compared between the two systems for up to two hours immediately after delivery. Researchers will evaluate the feasibility by checking for gaps in data and user satisfaction, assess safety through skin and pain scores, and measure accuracy using statistical comparisons. The study also includes monitoring the time between sensor placement and data display. Participation lasts only the initial two-hour period after birth, with monitoring done under real-world conditions in the obstetrical center.

This research aims to find out if giving plasma from a donor who recently had Chikungunya infection to newborns whose mothers have peripartum Chikungunya infection can improve the chances of newborns surviving without brain inflammation or damage within the first five days of life. The study will compare these results with a group of newborns who did not receive plasma transfusion due to delays in diagnosis or transfer, or parental refusal. The trial is led by the Centre Hospitalier Universitaire de la Réunion and includes newborns up to 2 days old. Participants in the treatment group will receive a plasma transfusion from donors who declared Chikungunya infection less than six months ago. This treatment is given to newborns whose mothers were diagnosed with Chikungunya infection around the time of birth. Newborns will be treated within 12 hours of birth or diagnosis depending on timing. There is also a parallel observational group of newborns who will not receive plasma but will be monitored as part of standard care. During the study, newborns will have daily medical and biological tests from day 1 to day 7, and a follow-up visit between 1 and 3 months of age. For the observational group, data collected during routine care up to 3 months will be used for research. Researchers will measure the effectiveness of early plasma administration in preventing neonatal brain inflammation or damage within five days after treatment. Safety and health will be monitored throughout the trial period, which is planned to end in late 2027.

Researchers are studying preterm infants born between 25 and 32 weeks of gestation to compare two methods of incubator temperature control and their effects on infant weight growth and health. The study is based on earlier findings that lower body temperature on admission relates to higher illness and death rates in preterm infants. It aims to see if using a new software to calculate personalized air temperature in incubators can improve growth and reduce side effects compared to the traditional skin temperature control method. The study compares two incubator control methods: air temperature control (ATC), which uses software to set air temperature to reduce body heat loss to zero, and skin servocontrol (SSC), which adjusts incubator temperature based on the infant's skin temperature. Both methods are evaluated in closed incubators for preterm infants. The trial randomly assigns infants to one of these two methods to study their effects during the first 10 days of life. Participants will be monitored for changes in body weight until day 10, along with comfort, thermal stress, and humidity challenges. The study also tracks neonatal illness occurrences up to 40 weeks of amenorrhea and length of hospital stay until discharge or 40 weeks of amenorrhea. Parents provide written consent, and infants are included within the first day of life. The study continues through hospitalization, assessing health outcomes and safety related to the incubator settings.

Researchers are studying the effects of arginine supplementation on immune function in infants who have undergone major bowel surgery or have necrotising enterocolitis. This exploratory study will compare gene expression related to immune response in preterm and term infants receiving different nutrition regimens. The goal is to understand how arginine affects genes involved in nutrition and infection in postoperative babies. The study involves 48 infants divided into three groups: one receiving standard parenteral nutrition without added arginine, one receiving parenteral nutrition with added arginine plus oral arginine supplementation, and one receiving standard parenteral nutrition with oral arginine supplementation only. Arginine dosing will begin with the first enteral feeds and adjust based on feeding progress. Treatment lasts up to 30 days post-surgery or diagnosis. Participants will have blood samples collected at specified intervals up to 30 days after surgery to analyze gene expression, amino acid levels, ammonia, and metabolomics. Routine nutritional intake and clinical lab data will also be recorded. Researchers will assess changes in immune-related gene activity, metabolomic profiles, and growth during the study period. The study is conducted across two neonatal centers under a neonatal partnership.

Phacoemulsification is a common cataract surgery performed under topical anesthesia, which is generally safe but can cause pain, anxiety, and discomfort for some patients. This research evaluates the effect of oral anti-anxiety medication, specifically Alprazolam, on improving patient satisfaction during second eye cataract surgery. The study aims to clarify whether oral sedation can reduce pain, anxiety, and side effects like nausea and dizziness compared to no sedation during phacoemulsification. Patients will receive either a single oral dose of Alprazolam or a placebo tablet 30 minutes before surgery. The dose of Alprazolam is 0.5 mg for most patients, with a reduced 0.25 mg dose for those over 65 years or with liver disease. The study compares these groups to assess how oral sedation affects anxiety, pain, and surgical satisfaction. This is an extension study involving patients undergoing surgery on their second eye with topical anesthesia. During the trial, participants will complete questionnaires assessing pain, anxiety, and overall satisfaction before and after surgery. Researchers will monitor intraoperative discomfort and postoperative anxiety levels. Data from approximately 250 patients will be collected and analyzed for these outcomes. This study runs from March 2025 to December 2027, focusing on improving cataract surgery experiences safely and conveniently.

Researchers are conducting an observational study to collect data on preterm babies with retinopathy of prematurity (ROP) who are treated with aflibercept (Eylea) delivered using a paediatric dosing device (PDD). ROP affects the eyes of preterm infants, especially those born before 32 weeks or weighing less than 1.5 kilograms, potentially leading to vision problems. The study aims to find out how many babies in the UK receive this treatment and to describe their characteristics and ROP symptoms. The treatment being studied is aflibercept, a drug injected into the eye to block abnormal blood vessel growth caused by ROP. It is given using a prefilled syringe combined with a paediatric dosing device to ensure safe and accurate dosing. The study collects data from babies treated with this method recorded in the National Neonatal Research Database from March 2024 to March 2025, or until April 2027 if more data is needed. Participants are not required to attend any visits or undergo tests for this study since only existing data from the database is used. Researchers will measure the number of babies treated with aflibercept using the PDD and summarize their characteristics, maternal factors, comorbidities, clinical conditions, resource use, outcomes, and ocular treatment details. The study will review data for up to three years following the drug's market introduction in the UK.