Prenatal Genetic Diagnosis by Genomic Sequencing (PrenatalSEQ)
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ClinicalTrials.gov Identifier: NCT03936101 |
Recruitment Status :
Recruiting
First Posted : May 3, 2019
Last Update Posted : October 24, 2022
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Tracking Information | |||||||||||||||||
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First Submitted Date | March 25, 2019 | ||||||||||||||||
First Posted Date | May 3, 2019 | ||||||||||||||||
Last Update Posted Date | October 24, 2022 | ||||||||||||||||
Actual Study Start Date | June 28, 2019 | ||||||||||||||||
Estimated Primary Completion Date | August 2023 (Final data collection date for primary outcome measure) | ||||||||||||||||
Current Primary Outcome Measures |
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Original Primary Outcome Measures | Same as current | ||||||||||||||||
Change History | |||||||||||||||||
Current Secondary Outcome Measures |
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Original Secondary Outcome Measures | Same as current | ||||||||||||||||
Current Other Pre-specified Outcome Measures | Not Provided | ||||||||||||||||
Original Other Pre-specified Outcome Measures | Not Provided | ||||||||||||||||
Descriptive Information | |||||||||||||||||
Brief Title | Prenatal Genetic Diagnosis by Genomic Sequencing | ||||||||||||||||
Official Title | Prenatal Genetic Diagnosis by Genomic Sequencing: A Prospective Evaluation | ||||||||||||||||
Brief Summary | This study is evaluating the impact of prenatal sequencing on the management of fetuses with ultrasound abnormalities. The hypothesis is that a significant subset of fetal abnormalities have a genetic cause that can be identified by sequencing and that prenatal knowledge of this information will improve prenatal care, reduce unnecessary diagnostic testing, reduce the cost of care, and improve the quality of life for both the child and the family. | ||||||||||||||||
Detailed Description | Whole exome and whole genome sequencing (WGS) have expanded the ability to determine the genetic etiology of previously undiagnosed disorders. This study is a multicenter prospective cohort study to evaluate the emerging technology of sequencing for the management of fetuses with structural anomalies. The hypothesis is that a significant subset of fetal structural anomalies has a genetic etiology identifiable by sequencing and that prenatal knowledge of this information will improve perinatal care, reduce unnecessary diagnostic testing, reduce the cost of care, and improve quality of life for both the child and the family. The aims of this study are to investigate these multiple aspects of prenatal sequencing in a single study with an innovative integrated prospective design, which will permit a robust evaluation of the benefits and risks of delivering diagnostic and prognostic genetic testing results in a prenatal setting. The study will determine, in a sequential population of pregnancies with selected fetal structural anomalies and a negative or non-causal chromosomal microarray (CMA), the frequency of pathogenic, likely pathogenic, and uncertain genomic variants identifiable by sequencing. To determine the impact of this information on clinical care, a control population of unsequenced pregnancies with similar structural anomalies will be prospectively recruited and the infants from both cohorts will be followed up to 1 year of age. This study component will evaluate differences in healthcare management and cost through discharge from hospital post-delivery, and perinatal and infant outcomes through 1 year of life. The educational, counseling and psychosocial impact of sequencing results during the prenatal period, in the nursery and through 1 year of life also will be evaluated. Since the analytical and clinical tools needed for the full translation of sequencing into care are still developing, optimization of bioinformatic tools to improve identification of pathogenic and likely pathogenic mutations associated with prenatal phenotypes of established disease genes will be investigated, as well as identification of new genes associated with presently undiagnosed fetal/neonatal phenotypes. This study will provide an in-depth evaluation of the prenatal diagnostic value of sequencing prior to its responsible introduction into practice and will provide independent data to guide its translation. |
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Study Type | Observational | ||||||||||||||||
Study Design | Observational Model: Case-Control Time Perspective: Prospective |
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Target Follow-Up Duration | Not Provided | ||||||||||||||||
Biospecimen | Retention: Samples With DNA Description: Remaining DNA from trios will be stored in a biorepository. Plasma from Streck tubes will be retained as well.
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Sampling Method | Non-Probability Sample | ||||||||||||||||
Study Population | A total of 1,100 pregnancies with fetal structural anomalies and meeting eligibility criteria will be enrolled into the study. Of these, 750 will undergo prenatal genomic sequencing (prenatal sequencing group) and the remaining 350 pregnancies will not have any prenatal genomic sequencing (unsequenced prenatal group). Enrollment of pregnancies with an isolated nuchal translucency measurements ≥ 3.5 mm will be restricted to 5% within each group (sequenced and unsequenced) and isolated estimated fetal weight <5th %ile also will be restricted to 5% for each group (sequenced and unsequenced). |
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Condition | Fetal Structural Anomalies | ||||||||||||||||
Intervention | Diagnostic Test: Prenatal Genomic Sequencing
Whole genome sequencing (which initially will be masked and reported as exome only)
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Study Groups/Cohorts |
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Publications * | Not Provided | ||||||||||||||||
* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline. |
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Recruitment Information | |||||||||||||||||
Recruitment Status | Recruiting | ||||||||||||||||
Estimated Enrollment |
1100 | ||||||||||||||||
Original Estimated Enrollment | Same as current | ||||||||||||||||
Estimated Study Completion Date | November 2023 | ||||||||||||||||
Estimated Primary Completion Date | August 2023 (Final data collection date for primary outcome measure) | ||||||||||||||||
Eligibility Criteria | Inclusion Criteria: Prenatal sequencing group
Unsequenced Group
Exclusion Criteria: Prenatal Sequencing Group
Unsequenced Group
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Sex/Gender |
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Ages | 18 Years and older (Adult, Older Adult) | ||||||||||||||||
Accepts Healthy Volunteers | Yes | ||||||||||||||||
Contacts |
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Listed Location Countries | United States | ||||||||||||||||
Removed Location Countries | |||||||||||||||||
Administrative Information | |||||||||||||||||
NCT Number | NCT03936101 | ||||||||||||||||
Other Study ID Numbers | AAAS2118 R01HD055651 ( U.S. NIH Grant/Contract ) |
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Has Data Monitoring Committee | No | ||||||||||||||||
U.S. FDA-regulated Product |
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IPD Sharing Statement |
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Current Responsible Party | Ronald J Wapner, MD, Columbia University | ||||||||||||||||
Original Responsible Party | Ronald J Wapner, MD, Columbia University, Director, Reproductive Genetics, Vice Chair of Research, Department of OBGYN | ||||||||||||||||
Current Study Sponsor | Columbia University | ||||||||||||||||
Original Study Sponsor | Same as current | ||||||||||||||||
Collaborators |
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Investigators |
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PRS Account | Columbia University | ||||||||||||||||
Verification Date | October 2022 |