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MicroRNA Biomarkers for Neonatal Opioid Withdrawal Syndrome

Recruiting
Conditions
Neonatal Opioid Withdrawal Syndrome
Neonatal Abstinence Syndrome
Interventions
Genetic: Buccal swab saliva for further genetic testing
Registration Number
NCT05937594
Lead Sponsor
Milton S. Hershey Medical Center
Brief Summary

Infants with neonatal abstinence syndrome (NAS) experience prolonged hospital stays and poor neurodevelopmental outcomes, in-part because of the lack of accurate, individualized, biologic assessments available to manage this increasingly common medical condition. The proposed study will define the molecular mechanisms that regulate the response to opioid withdrawal in the developing brain by focusing on three candidate microRNAs (let-7a, miR-146a, miR-192) that have been shown to respond to opioid exposure in animal models and adults, and are impacted in both my preliminary study of infants with NAS, and my human neural progenitor cell (NPC) design of opioid withdrawal. By determining the mechanism through which microRNAs impact NPC differentiation in opioid withdrawal, and determining whether exosomal salivary microRNA levels predict treatment dose and neurodevelopmental outcomes in infants with NAS, this study will enhance our knowledge of NAS-related biology and identify potential biomarkers that could improve medical care for this important medical condition.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
50
Inclusion Criteria
  • Newborns ≥35weeks gestation with chronic in-utero opioid exposure (>1month of gestation exposure). Maternal exposure will be determined by evaluating the medical records for maternal medication use, maternal urine toxicology and neonatal meconium toxicology results per standard clinical care
  • Neonates born at Penn State Hershey Medical Center or transferred at <48 hours after birth
  • Mothers with chronic in-utero opioid use during pregnancy ( ≥1month of gestation)
Exclusion Criteria
  • <35 week gestation
  • Infant required mechanical ventilation or non-invasive mechanical support
  • Infant exposure to magnesium sulfate
  • Opioid-exposed neonates who are actively receiving dextrose infusion for persistent neonatal hypoglycemia at the time of enrollment (<48hours after birth).
  • Infant with major congenital anomalies
  • Parent or guardian unable to provide consent
  • Mothers and neonates without history of opioid exposure/dependence

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Infants exposed to in utero opiatesBuccal swab saliva for further genetic testingInfants that meet IRB-approved inclusion/exclusion criteria.
Primary Outcome Measures
NameTimeMethod
Neurodevelopmental outcome scores6 months of age

Measured by Ages and Stages Questionnaire-3, score scale 0-60

Maximum concentration of morphine required for withdrawal symptom controlMeasured during the course of hospital stay

Measured in mg/kg/ml

Salivary level of microRNA-146aBuccal swab collected within 96 hrs of life and at discharge

Relative fluorescence (Cq) measured by qPCR using established housekeeping gene

Salivary level of microRNA-192Buccal swab collected within 96 hrs of life and at discharge

Relative fluorescence (Cq) measured by qPCR using established housekeeping gene

Salivary level of microRNA-149-3pBuccal swab collected within 96 hrs of life and at discharge

Relative fluorescence (Cq) measured by qPCR using established housekeeping gene

Salivary microRNA level let-7aBuccal swab collected within 96 hrs of life and at discharge

Relative fluorescence (Cq) measured by qPCR using established housekeeping gene

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Penn State Milton S. Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

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