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Trial registered on ANZCTR
Registration number
ACTRN12617001206314p
Ethics application status
Submitted, not yet approved
Date submitted
12/08/2017
Date registered
17/08/2017
Date last updated
17/08/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Investigation of the effect on babies of mothers consuming carbohydrate drink prior to caesarean delivery
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Scientific title
Effect of peripartum maternal carbohydrate load pre caesarean section on neonatal blood glucose
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Secondary ID [1]
292644
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pregnant women undergoing elective caesarean section
304377
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Condition category
Condition code
Metabolic and Endocrine
303705
303705
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0
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Normal metabolism and endocrine development and function
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Reproductive Health and Childbirth
303730
303730
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0
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Childbirth and postnatal care
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Mothers will be randomised to either control or intervention arm.
Intervention arm women will be asked to consumed 200 grams of oral complex carbohydrate drink (Nutricia PreOp which contains 50 grams of complex carbohydrate per 200mls) the evening prior to elective caesarean section, and 100 grams on the morning of caesarean section. Mother and neonatal serum blood glucose level will be tested at fixed points following delivery of the fetus. Specifically fetal blood sugar will be measured at 4 and 10 hours of age - corresponding to before their second and fourth feed. Management of neonate blood sugar thereafter will be as per our local guideline.
Following randomisation and allocation of intervention or placebo arm, our research nurse with over 15 years experience will issue each study participant with their drink. This will take place face to face.
To ensure and maintain blinding, each study participant will receive a two drinks to consume. One the night prior to their caesarean section, and the second to be consumed between one and two hours prior to their surgery.
The first drink will be consumed at the participants home, and the second most likely in our day of surgery admission unit.
Prior to the testing of blood serum glucose concentration, study participants will be asked to verbally confirm that they have consumed both study drinks that were issued to them. verbal confirmation will be deemed adequate confirmation.
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Intervention code [1]
298877
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Treatment: Other
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Comparator / control treatment
Control arm women will receive a simple sugar free flavoured water drink, both the night before and the day of surgery in a similar ilk to the intervention arm.
The remainder of their care will follow our local peri and post operative caesarean section pathway guidelines.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Neonatal blood glucose concentration
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Assessment method [1]
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Timepoint [1]
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four and ten hours of age
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Primary outcome [2]
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Admission to neonatal nursery for hypoglycaemia management
Neonatal record will provide means to identify admission to our neonatal nursery. This will be collated at time of final data collection / checking for each subject. Admission reason can be identified on neonatal discharge summary.
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Assessment method [2]
303072
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Timepoint [2]
303072
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Within first 24 hours of life
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Secondary outcome [1]
337821
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Requirement of admission to neonatal nursery for any cause.
Neonatal record will provide means to identify admission to our neonatal nursery. This will be collated at time of final data collection and checking for each subject. Admission reason can be identified on neonatal discharge summary.
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Assessment method [1]
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Timepoint [1]
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Duration of maternal and fetal admission
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Secondary outcome [2]
337822
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Maternal blood glucose concentration during caesarean section.
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Assessment method [2]
337822
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Timepoint [2]
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Maternal blood sugar will be checked during elective caesarean section. This will be after neuraxial blockade has been placed, but before fetus is delivered.
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Secondary outcome [3]
337823
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Requirement of neonate for formula supplementation during hospitalisation. On discharge from hospital, fetal medical records will be examined for documentation of necessity for neonatal formula feed top up.
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Assessment method [3]
337823
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Timepoint [3]
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Duration of hospitalisation
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Secondary outcome [4]
337824
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Maternal requirement of medication for postoperative nausea. This is defined as the administration of an additional anti-emetic medication above the routine administration of 4mg Ondansteron intravenously as part of routine caesarean section care.
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Assessment method [4]
337824
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Timepoint [4]
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Peri-operative period (Pre operative until leaving from Recovery room in theatre suite)
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Secondary outcome [5]
337825
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Length of hospital stay
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Assessment method [5]
337825
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Timepoint [5]
337825
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Discharge from inpatient care
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Eligibility
Key inclusion criteria
1. Pregnant women undergoing elective caesarean section
2. Term gestational age (37+0 to 41+6 weeks)
3. Singleton gestation
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Minimum age
18
Years
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Maximum age
50
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Women with gestational diabetes and diabetes mellitus
2. Fetal intrauterine growth restriction
3. Ante-natally detected congenital anomaly which will require admission to neonatal nursery
4. Non English speaking
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer sequence generation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
30/10/2017
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Actual
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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
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
8793
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King Edward Memorial Hospital - Subiaco
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Recruitment postcode(s) [1]
16916
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6008 - Subiaco
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Funding & Sponsors
Funding source category [1]
297273
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Charities/Societies/Foundations
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Name [1]
297273
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Australian Society of Anaesthetists
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Address [1]
297273
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Funding has been applied for - awaiting funding decision.
Australian Society of Anaesthetists
PO Box 6278
North Sydney, NSW 2059
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Country [1]
297273
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Australia
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Primary sponsor type
Individual
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Name
Associate CLinical Professor Nolan McDonnell
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Address
King Edward Memorial Hospital
374 Bagot Road
Subiaco
Perth
6008
WA
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Country
Australia
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Secondary sponsor category [1]
296248
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Individual
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Name [1]
296248
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Dr Elizabeth Beattie
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Address [1]
296248
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King Edward Memorial Hospital
374 Bagot Road
Subiaco
Perth
6008
WA
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Country [1]
296248
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Australia
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Secondary sponsor category [2]
296249
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Individual
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Name [2]
296249
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Dr Abhijeet Rakshasbhuvankar
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Address [2]
296249
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King Edward Memorial Hospital
374 bagot Road
Subiaco
Perth
6008
WA
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Country [2]
296249
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Australia
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
298390
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Womans and Newborn Health Human Research Ethics Committee
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Ethics committee address [1]
298390
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374 Bagot Road Subiaco Perth 6008 WA
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Ethics committee country [1]
298390
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Australia
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Date submitted for ethics approval [1]
298390
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31/07/2017
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Approval date [1]
298390
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Ethics approval number [1]
298390
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Summary
Brief summary
Background: An enhanced recovery strategy involves various pre, intra, and postoperative steps to reduce the normal stress response and organ dysfunction associated with surgical insult, with the ultimate aim of reducing time to full recovery. Preoperative carbohydrate administration is one of the components of an enhanced recovery strategy. However, preoperative carbohydrate treatment for pregnant women undergoing elective caesarean section has the potential to cause rebound hypoglycaemia in the newborn infant. The glycaemic control of newborn infants born to mothers receiving preoperative carbohydrate loading, as a part of an enhanced recovery strategy has not previously been studied. Methods: We propose a pilot randomized controlled clinical trial to investigate the effect of preoperative carbohydrate loading in pregnant women undergoing elective caesarean section, on the glycaemic control of newborn infants. One hundred pregnant women scheduled for an elective caesarean section will be recruited after informed consent. They will be randomised to either intervention or control arm, and receive preoperative carbohydrate loading or no carbohydrate loading respectively. The remainder of their peri-operative management will be as per King Edward Memorial Hospital (KEMH) protocol for enhanced recovery. Newborn infants will be monitored for the risk of hypoglycaemia using KEMH neonatal unit guidelines for “infants at risk of hypoglycaemia”. Outcomes: The primary outcomes will be blood glucose concentration in newborn infant at four and ten hours of life, and the requirement for admission to newborn nursery for the management of hypoglycaemia. Secondary outcomes will include maternal blood glucose concentration during caesarean section, maternal medication requirement for postoperative nausea, and length of hospital stay. Significance: If the study shows that should this pilot study show that pre caesarean section carbohydrate does not increase risk of hypoglycaemia in newborn infants, we can safely introduce this component to our enhanced recovery protocol. Pre caesarean section carbohydrate loading has the potential to enhance maternal recovery and decrease length of hospital stay resulting in financial saving.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
1965
1965
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/AnzctrAttachments/373466-MCMG protocol v1.docx
(Protocol)
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Attachments [2]
1966
1966
0
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/AnzctrAttachments/373466-Patient consent v2.doc
(Participant information/consent)
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Attachments [3]
1967
1967
0
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/AnzctrAttachments/373466-6076_Carbohydrate info sheetv1.docx
(Participant information/consent)
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Attachments [4]
1968
1968
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/AnzctrAttachments/373466-6075_Data record sheetv3.docx
(Other)
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Contacts
Principal investigator
Name
76922
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A/Prof Nolan McDonnell
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Address
76922
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King Edward Memorial Hospital
374 Bagot Road
Subiaco
Perth
6008
WA
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Country
76922
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Australia
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Phone
76922
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+6186458 2222
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Fax
76922
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Email
76922
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[email protected]
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Contact person for public queries
Name
76923
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Desiree Cavill
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Address
76923
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King Edward Memorial Hospital
374 Bagot Road
Subiaco
Perth
6008
WA
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Country
76923
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Australia
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Phone
76923
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+6186458 2222
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Fax
76923
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Email
76923
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[email protected]
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Contact person for scientific queries
Name
76924
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Nolan McDonnell
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Address
76924
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King Edward Memorial Hospital
374 Bagot Road
Subiaco
Perth
6008
WA
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Country
76924
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Australia
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Phone
76924
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+6186458 2222
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Fax
76924
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Email
76924
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[email protected]
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No information has been provided regarding IPD availability
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