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Neurodevelopmental AbnormalityNCT04888377

ASPIRIN: Neurodevelopmental Follow-up Trial

An observational study of Neurodevelopmental Abnormality, run by NICHD Global Network for Women's and Children's Health at 14 sites in 6 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

A total of 620 children will be enrolled in this study from six sites in sub-Saharan Africa, South Asia, and Latin America. Half of the children's mothers will have taken aspirin and half will have taken placebo. Read more about this study

Who is it for?
Ages 33 to 39 monthsHealthy volunteers can take part
Conditions the study is for
Neurodevelopmental Abnormality
What is being tested?
Aspirin
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
666 participants
Where
14 sitesin 6 countries
Study dates
1 Sep 2021to 15 Jun 2022
Phase
Observational
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 33 to 39 months
  • All sexes
  • Healthy volunteers accepted
  • Child

Study population: The study population will consist of approximately 620 children, between 33 and 39 months of age, whose mothers were included in the ASPIRIN trial.

Who may be able to join

  • Mother was enrolled in the GN ASPIRIN trial
  • Mother consented to be recontacted
  • Child's parents or guardians are willing and able to give consent
  • Child is between 33-39 months of age
  • Child does not have significant congenital anomaly (blind or deaf) that would affect them from completing study assessments
  • Child does not have other medical conditions that would preclude the child from completing study assessments.

Who cannot join

  • The child does not meet the inclusion criteria.

Trial locations and contacts

14 sites in 6 countries.

14 sites in 6 countries

United States8 sites
  • University of Alabama, Birmingham

    Birmingham, Alabama, 35233

  • Boston University

    Boston, Massachusetts, 02115

  • University of North Carolina School of Medicine

    Chapel Hill, North Carolina, 27599

  • University of Colorado Health Sciences Center

    Denver, Colorado, 80208

  • Columbia University

    New York, New York, 10032

  • Christiana Care

    Newark, Delaware, 19718

  • Thomas Jefferson University

    Philadelphia, Pennsylvania, 19107

  • RTI International

    Research Triangle Park, North Carolina, 27709

Other trials in United States

India2 sites
  • Jawaharlal Nehru Medical College

    Belagavi

  • Lata Medical Research Foundation

    Nagpur

Other trials in India

Democratic Republic of the Congo1 site
  • Kinshasa School of Public Health

    Kinshasa

Other trials in Democratic Republic of the Congo

Guatemala1 site
  • INCAP

    Guatemala City

Other trials in Guatemala

Pakistan1 site
  • Aga Khan University

    Karachi

Other trials in Pakistan

Zambia1 site
  • University Teaching Hospital

    Lusaka

Other trials in Zambia

About this study

Official title: Aspirin Supplementation for Pregnancy Indicated Risk Reduction in Nulliparas (ASPIRIN): Neurodevelopmental Follow-up Trial

A total of 620 children will be enrolled in this study from six sites in sub-Saharan Africa, South Asia, and Latin America. Half of the children's mothers will have taken aspirin and half will have taken placebo. This will allow the researchers to compare results of the two groups of children and determine if children exposed antenatally to low dose aspirin will have scores on the Bayley Scales of Infant Development-III (BSID-III) examination at 36 months of life (+/-3months) that are not inferior to the child's peers who were not exposed (i.e., by no more than a margin of 4 points).

Read the detailed description

An estimated 250 million children under the age of 511 worldwide are at risk for not achieving their developmental potential; 52.9 million children under five years of age in low- and middle-income country (LMIC) settings have neurodevelopmental delays. Compounding the issue is preterm birth (more common in LMICs) which has consistently been identified as a cause of neurodevelopmental delay. A recent review reported that out of the estimated 13 million preterm infants who survive beyond the first month, 0.9 million will suffer long term neurodevelopmental impairment, with 345,000 moderately or severely affected. This burden places a significant strain on the families, healthcare systems and societies that provide care for these children. Data from other Global Network participating sites (Guatemala, Democratic Republic of Congo, Zambia and Pakistan) also found strikingly high rates of stunting ranging from 44% to 66%, among infants and toddlers. Poverty additionally contributes to the attainment of optimal neurodevelopment. As such, any study of neurodevelopment should at least document these potential confounders.

Aspirin has been shown to predominantly affect both the COX-1 pathway which is involved in thrombosis and the COX-2 pathway, which affects inflammation through the production of Aspirin Triggered Lipoxins. More specifically, aspirin has been shown to inhibit the production of IL-6, IL-1B, CRP and TNF-α all of which have been shown to negatively affect child neurodevelopment and be involved in preeclampsia and preterm birth.

This will be a prospective masked matched cohort study of children between 33 and 39 months (mean 36 months) of age whose mothers were randomized in the ASPIRIN trial *NCT02409680* (1:1 Aspirin-Placebo), who will be evaluated using the BSID-III. Additionally, the Family Resources and Context questionnaire will be performed to adjust for the local context and the ASQ-3 will be administered as a secondary screen. Recognizing the significant role that preterm birth plays in neurodevelopment, the investigators will include 100 (50 in each group) children who were delivered before 37 weeks.

Being tested
Aspirin, Placebo
Keywords
Pre-eclampsia, Low Dose Aspirin, ASPIRIN Trail, NICHD Global Network, Global Network, ASPRIN Follow Up, BSID-III, Family Resources and Context, ASQ-36, Neurodevelopmental delays, hypertensive disorders of pregnancy (HDP), Pre-term birth, LDA
Medical subject headings
Pre-Eclampsia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AspirinDrug

    Participant's mothers were administered 81mg of Aspirin throughout their pregnancy with the participant.

  • PlaceboDrug

    Participant's mothers were administered placebo throughout their pregnancy with the participant.

Study groups in NCT04888377
Study groupRoleWhat they receive
Antenatal exposure to low dose aspirinMothers in the Global Networks ASPIRIN trial were given 81 mg of Aspirin throughout their pregnancy with the follow-up studies participant.
Receives: Drug: Aspirin
Antenatal exposure to PlaceboMothers in the Global Networks ASPIRIN trial were given placebo throughout their pregnancy with the follow-up studies participant.
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) Cognitive Composite Score

    Mean of the Bayley-III Cognitive Composite Score (standardized mean 100, SD 15, range 55-155) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

Secondary outcomes (18)
  1. Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) Cognitive Composite Score Less Than 70

    Number of participants with the Bayley-III Cognitive Composite score less than 70 (standardized mean 100, SD 15, range 55-155) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  2. Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) Cognitive Composite Score Less Than 1 Standard Deviation (SD) Below the Mean

    Number of participants with the Bayley-III Cognitive Composite score less than 1 SD below the sample mean (standardized mean 100, SD 15, range 55-155) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  3. Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) Language Composite Score

    Mean of the Bayley-III Language Composite Score (standardized mean 100, SD 15, range 45-155) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  4. Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) Language Composite Score Less Than 70

    Number of participants with the Bayley-III Language Composite score less than 70 (standardized mean 100, SD 15, range 45-155) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  5. Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) Language Composite Score Less Than 1 Standard Deviation (SD) Below the Mean

    Number of participants with the Bayley-III Language Composite score less than 1 SD below the sample mean (standardized mean 100, SD 15, range 45-155) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  6. Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) Motor Composite Score

    Mean of the Bayley-III Motor Composite Score (standardized mean 100, SD 15, range 45-155) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  7. Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) Motor Composite Score Less Than 70

    Number of participants with the Bayley-III Motor Composite score less than 70 (standardized mean 100, SD 15, range 45-155) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  8. Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) Motor Composite Score Less Than 1 Standard Deviation (SD) Below the Mean

    Number of participants with the Bayley-III Motor Composite score less than 1 SD below the sample mean (standardized mean 100, SD 15, range 45-155) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  9. Ages and Stages Questionnaire, 3rd Edition (ASQ-3) Communication Total Score

    Mean of the ASQ Communication Total Score (range 0-60) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  10. Ages and Stages Questionnaire, 3rd Edition (ASQ-3) Communication Total Score Less Than 1 Standard Deviation (SD) Below the Mean

    Number of participants with the ASQ Communication Total score less than 1 SD below the sample mean (range 0-60) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  11. Ages and Stages Questionnaire, 3rd Edition (ASQ-3) Gross Motor Total Score

    Mean of the ASQ Gross Motor Total Score (range 0-60) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  12. Ages and Stages Questionnaire, 3rd Edition (ASQ-3) Gross Motor Total Score Less Than 1 Standard Deviation (SD) Below the Mean

    Number of participants with the ASQ Gross Motor Total score less than 1 SD below the sample mean (range 0-60) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  13. Ages and Stages Questionnaire, 3rd Edition (ASQ-3) Fine Motor Total Score

    Mean of the ASQ Fine Motor Total Score (range 0-60) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  14. Ages and Stages Questionnaire, 3rd Edition (ASQ-3) Fine Motor Total Score Less Than 1 Standard Deviation (SD) Below the Mean

    Number of participants with the ASQ Fine Motor Total score less than 1 SD below the sample mean (range 0-60) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  15. Ages and Stages Questionnaire, 3rd Edition (ASQ-3) Problem Solving Total Score

    Mean of the ASQ Problem Solving Total Score (range 0-60) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  16. Ages and Stages Questionnaire, 3rd Edition (ASQ-3) Problem Solving Total Score Less Than 1 Standard Deviation (SD) Below the Mean

    Number of participants with the ASQ Problem Solving Total score less than 1 SD below the sample mean (range 0-60) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  17. Ages and Stages Questionnaire, 3rd Edition (ASQ-3) Personal Social Total Score

    Mean of the ASQ Personal Social Total Score (range 0-60) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

  18. Ages and Stages Questionnaire, 3rd Edition (ASQ-3) Personal Social Total Score Less Than 1 Standard Deviation (SD) Below the Mean

    Number of participants with the ASQ Personal Social Total score less than 1 SD below the sample mean (range 0-60) (lower scores indicating greater impairment)

    Measured: At a single visit occurring between 33-39 months corrected age

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 May 2021
  2. Study start1 Sep 2021
  3. Primary completion15 Jun 2022
  4. Study completion15 Jun 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
666 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04888377
Sponsor's protocol ID
GN ASPIRIN Follow Up
Status last verified
Jul 2024
First submitted
28 Apr 2021
Last updated
21 Oct 2024
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: The plan is to release primary results from the study.

Publications

  • Hoffman MK, Goudar S, Dhaded S, Figueroa L, Mazariegos M, Krebs NF, Westcott J, Tikmani SS, Karim F, Saleem S, Goldenberg RL, Lokangaka A, Tshefu A, Bauserman M, Patel A, Das P, Hibberd P, Chomba E, Mwenchanya M, Carlo WA, Trotta M, Williams A, Moore J, Nolen T, Goco N, McClure EM, Lobo MA, Cunha AB, Derman RJ. Neurodevelopment of Children Whose Mothers Were Randomized to Low-Dose Aspirin During Pregnancy. Obstet Gynecol. 2024 Apr 1;143(4):554-561. doi: 10.1097/AOG.0000000000005514. Epub 2024 Jan 23.

    PubMed 38262066

Questions about this trial

What is this clinical trial studying?

An observational study of Neurodevelopmental Abnormality, run by NICHD Global Network for Women's and Children's Health at 14 sites in 6 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 14 sites in United States, India, Democratic Republic of the Congo, Guatemala, Pakistan and 1 more country. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 21 Oct 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) Cognitive Composite Score (time frame: At a single visit occurring between 33-39 months corrected age). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04888377, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Oct 2024.

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