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Trial registered on ANZCTR


Registration number
ACTRN12625000973415
Ethics application status
Approved
Date submitted
7/08/2025
Date registered
4/09/2025
Date last updated
4/09/2025
Date data sharing statement initially provided
4/09/2025
Type of registration
Prospectively registered

Titles & IDs
Public title
DELIGHT Pilot Study: Delayed cord clamping in newborns with antenatal diagnosis of critical congenital heart disease
Scientific title
Delayed cord clamping in newborns with antenatal diagnosis of critical congenital heart disease: a pilot randomised controlled trial examining effect of delayed cord clamping on haematocrit
Secondary ID [1] 315033 0
None
Universal Trial Number (UTN)
Trial acronym
DELIGHT Pilot Study
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Congenital heart disease 338454 0
Condition category
Condition code
Reproductive Health and Childbirth 334752 334752 0 0
Childbirth and postnatal care
Cardiovascular 334785 334785 0 0
Other cardiovascular diseases

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
The intervention is delayed clamping of the umbilical cord, for at least 60 seconds after delivery.

To administer the intervention:
* A nominated staff member (e.g. obstetrician or midwife) will call out clearly as soon as the infant has been delivered
* A nominated staff member (e.g. neonatal team member) will start the clock on the resuscitation trolley when the infant has been delivered and call out the time clearly in seconds.
* A nominated staff member (e.g. neonatal team member) will time and record the duration of the allocated intervention
* A nominated staff member (e.g. obstetrician or midwife) will record the time when the cord has been clamped.

The cord should be clamped 6 centimetres from the umbilicus. During the delay, the infant will be held in a sterile towel, at or up to 30 centimetres below the level of the vaginal introitus (for vaginal delivery) or the level of the incision (for Caesarean section). Time in seconds of cord clamping should be recorded. After cutting of the cord, the infant will receive routine care. If an infant is deemed to required immediate resuscitation, delayed cord clamping should be abandoned and the cord clamped immediately with time in seconds of cord clamping accurately recorded. Time in seconds of cord clamping should be recorded for all infants.

A secondary outcome of this study is to measure compliance to delayed cord clamping. This will be obtained by recording the reasons for not complying with the delay of 60 seconds in the broad categories of concern about pregnant individual, concern about infant, parent preference and others. Study teams should be counselled appropriately if a sustained pattern or non-compliance is determined by the coordinating centre as part of data monitoring.
Intervention code [1] 331681 0
Prevention
Comparator / control treatment
The comparator is early clamping of the umbilical cord within 15 seconds after delivery of the infant.

To administer the intervention:
* A nominated staff member (e.g. obstetrician or midwife) will call out clearly as soon as the infant has been delivered
* A nominated staff member (e.g. neonatal team member) will start the clock on the resuscitation trolley when the infant has been delivered and call out the time clearly in seconds.
* A nominated staff member (e.g. neonatal team member) will time and record the duration of the allocated intervention
* A nominated staff member (e.g. obstetrician or midwife) will record the time when the cord has been clamped.

The cord should be clamped 6 centimetres from the umbilicus. During the delay, the infant will be held in a sterile towel, at or up to 30 centimetres below the level of the vaginal introitus (for vaginal delivery) or the level of the incision (for Caesarean section). Time in seconds of cord clamping should be recorded. After cutting of the cord, the infant will receive routine care. Time in seconds of cord clamping should be recorded for all infants.
Control group
Active

Outcomes
Primary outcome [1] 342399 0
Haematocrit
Timepoint [1] 342399 0
At admission to the neonatal intensive care unit (no later than 6 hours of life)
Secondary outcome [1] 450694 0
Haemoglobin
Timepoint [1] 450694 0
At admission to the neonatal intensive care unit (no later than 6 hours of life)
Secondary outcome [2] 450741 0
Proportion of infants who receive at least one packed cell transfusion
Timepoint [2] 450741 0
From birth until hospital discharge
Secondary outcome [3] 450742 0
Number of packed red blood cell transfusions
Timepoint [3] 450742 0
From birth until hospital discharge
Secondary outcome [4] 450743 0
Proportion of infants who receive inotropic medication
Timepoint [4] 450743 0
At any time in the first 24 hours of life, commencing from time of birth.
Secondary outcome [5] 450745 0
Proportion of infants who experience hypotension
Timepoint [5] 450745 0
At any time in the first 24 hours of life, commencing from time of birth
Secondary outcome [6] 450746 0
Consent rate
Timepoint [6] 450746 0
At the conclusion of recruitment
Secondary outcome [7] 450747 0
Recruitment rate
Timepoint [7] 450747 0
At the conclusion of recruitment
Secondary outcome [8] 450749 0
Recruitment rate within different severity categories (composite)
Timepoint [8] 450749 0
At the conclusion of recruitment
Secondary outcome [9] 450751 0
Compliance to delayed cord clamping
Timepoint [9] 450751 0
At the conclusion of the study intervention period
Secondary outcome [10] 450753 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (hospital stay)
Timepoint [10] 450753 0
From NICU admission to hospital discharge
Secondary outcome [11] 450754 0
Safety outcome measures
Timepoint [11] 450754 0
From birth to 72 hours of life
Secondary outcome [12] 451185 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of 3-4 month follow-up outcome data as a primary outcome for definitive RCT
Timepoint [12] 451185 0
3-4 months corrected for prematurity
Secondary outcome [13] 451186 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of 12 month follow-up outcome data as a primary outcome for definitive RCT (subject to further funding)
Timepoint [13] 451186 0
12 months corrected for prematurity
Secondary outcome [14] 451578 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (survival to discharge)
Timepoint [14] 451578 0
From NICU admission to hospital discharge or 30 days after cardiac intervention (whichever is earlier)
Secondary outcome [15] 451579 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (necrotising enterocolitis)
Timepoint [15] 451579 0
Prior to cardiac intervention
Secondary outcome [16] 451580 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (shock)
Timepoint [16] 451580 0
Prior to cardiac intervention
Secondary outcome [17] 451581 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (mechanical ventilation)
Timepoint [17] 451581 0
Prior to cardiac intervention
Secondary outcome [18] 451582 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (renal failure)
Timepoint [18] 451582 0
Prior to cardiac intervention
Secondary outcome [19] 451583 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (complications - bleeding)
Timepoint [19] 451583 0
From cardiac intervention to 30 days after cardiac intervention or prior to hospital discharge (if discharged >30 days)
Secondary outcome [20] 451584 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (complications - multi-system organ failure)
Timepoint [20] 451584 0
From cardiac intervention to 30 days after cardiac intervention or prior to hospital discharge (if discharged >30 days)
Secondary outcome [21] 451585 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (complications - mechanical circulatory support)
Timepoint [21] 451585 0
From cardiac intervention to 30 days after cardiac intervention or prior to hospital discharge (if discharged >30 days)
Secondary outcome [22] 451586 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (complications - respiratory insufficiency)
Timepoint [22] 451586 0
From cardiac intervention to greater than 7 days after cardiac intervention.
Secondary outcome [23] 451587 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (complications - persistent neurological deficit)
Timepoint [23] 451587 0
From cardiac intervention to hospital discharge
Secondary outcome [24] 451588 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (complications - transient neurological deficit)
Timepoint [24] 451588 0
From cardiac intervention to hospital discharge
Secondary outcome [25] 451589 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (complications - respiratory failure requiring tracheostomy)
Timepoint [25] 451589 0
From cardiac intervention to 30 days after cardiac intervention or prior to hospital discharge (if discharged >30 days)
Secondary outcome [26] 451590 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (complications - unplanned cardiac reoperation)
Timepoint [26] 451590 0
From cardiac intervention to 30 days after cardiac intervention or prior to hospital discharge (if discharged >30 days)
Secondary outcome [27] 451591 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (complications - unplanned interventional cardiovascular catheterisation procedure)
Timepoint [27] 451591 0
From cardiac intervention to 30 days after cardiac intervention or prior to hospital discharge (if discharged >30 days)
Secondary outcome [28] 451592 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (complications - acute renal failure requiring dialysis)
Timepoint [28] 451592 0
At death or hospital discharge
Secondary outcome [29] 451593 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (complications - acute renal failure requiring temporary dialysis)
Timepoint [29] 451593 0
At death or hospital discharge
Secondary outcome [30] 451594 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (complications - cardiac arrest during or following cardiac intervention)
Timepoint [30] 451594 0
From cardiac intervention to 30 days after cardiac intervention or prior to hospital discharge (if discharged >30 days)
Secondary outcome [31] 451595 0
Refinement of a suitable primary outcome measure for definitive randomised controlled trial (RCT): feasibility of hospital outcome data as a primary outcome for definitive RCT (complications - unplanned readmission to hospital)
Timepoint [31] 451595 0
Within 30 days following cardiac intervention.

Eligibility
Key inclusion criteria
1. Term or late preterm foetus, greater than 34 weeks gestation, with an antenatal diagnosis of critical congenital heart disease diagnosed by foetal cardiologist

2. Antenatal foetal cardiovascular disease severity scale (FDSS) score of 3-6 (inclusive)

3. Written informed consent provided by the pregnant individual (parent)
Minimum age
34 Weeks
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
1. Foetuses with known genetic or major extracardiac anomalies, including Trisomy 21

2. Foetuses for whom palliative care is planned from delivery

3. Foetuses of pregnant individuals with current placental abruption or placenta previa

Study design
Purpose of the study
Prevention
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by computer
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The method of generating the allocation sequence is computer generated random numbers. Randomisation will be via permuted block randomisation. The randomisation will be stratified by hospital site (2 sites) and FDSS score (5-6 vs. 3-4).
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
Phase
Not Applicable
Type of endpoint/s
Safety/efficacy
Statistical methods / analysis
A sample size of 90 infants (45 per treatment arm) would provide 90% power (alpha=0.05) to detect superiority of delayed cord clamping over early cord clamping, assuming a mean difference in haematocrit of 5%, a standard deviation of 5 and accounting for 30% non-compliance.

All analyses will be prespecified in a statistical analysis plan and performed by intention to treat. Haematocrit will be analysed using a 2-sample t-test, and a mean difference (with 95% confidence interval) will be calculated. Other outcomes will be calculated as proportions or means with 95% confidence intervals.

Recruitment
Recruitment status
Not yet recruiting
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
NSW,QLD

Funding & Sponsors
Funding source category [1] 319597 0
Government body
Name [1] 319597 0
Commonwealth Department of Health, Disability and Ageing, Medical Research Future Fund (MRFF)
Country [1] 319597 0
Australia
Primary sponsor type
University
Name
The University of Sydney
Address
Country
Australia
Secondary sponsor category [1] 322099 0
None
Name [1] 322099 0
Address [1] 322099 0
Country [1] 322099 0

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 318162 0
Hunter New England Human Research Ethics Committee
Ethics committee address [1] 318162 0
Ethics committee country [1] 318162 0
Australia
Date submitted for ethics approval [1] 318162 0
31/07/2025
Approval date [1] 318162 0
20/08/2025
Ethics approval number [1] 318162 0
2025/ETH01678

Summary
Brief summary
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 143310 0
Dr Himanshu Popat
Address 143310 0
NHMRC Clinical Trials Centre, Locked Bag 77, Camperdown NSW 1450
Country 143310 0
Australia
Phone 143310 0
+61 2 9845 2714
Fax 143310 0
Email 143310 0
Contact person for public queries
Name 143311 0
Ms Sarah Finlayson
Address 143311 0
NHMRC Clinical Trials Centre, Locked Bag 77, Camperdown NSW 1450
Country 143311 0
Australia
Phone 143311 0
+61 2 9562 5347
Fax 143311 0
Email 143311 0
Contact person for scientific queries
Name 143312 0
Himanshu Popat
Address 143312 0
NHMRC Clinical Trials Centre, Locked Bag 77, Camperdown NSW 1450
Country 143312 0
Australia
Phone 143312 0
+61 2 9845 2714
Fax 143312 0
Email 143312 0

Data sharing statement
Will the study consider sharing individual participant data?
Yes
Will there be any conditions when requesting access to individual participant data?
Persons/groups eligible to request access:
Researchers
Conditions for requesting access:
Yes, conditions apply:
Requires review on a case-by-case basis by the trial custodian, sponsor or data sharing committee
Requires a scientifically sound proposal or protocol
Requires approval by an ethics committee
Requires a data sharing agreement between data requester and trial custodian or sponsor
What individual participant data might be shared?
All de-identified individual participant data
What types of analyses could be done with individual participant data?
Any type of analysis (i.e. no restrictions on data re-use)
When can requests for individual participant data be made (start and end dates)?
From:
After publication of main results
To:
No end date
Where can requests to access individual participant data be made, or data be obtained directly?
Email of trial custodian, sponsor or committee: Provide request in writing to [email protected]

Are there extra considerations when requesting access to individual participant data?
Yes: Data sharing must comply with University of Sydney policies, and NHMRC Clinical Trial Centre SOPs. Data sharing can only be performed in line with the consent given by participants.



What supporting documents are/will be available?

TypeCitationLinkEmailOther DetailsAttachment
Study protocol    To be published in peer-reviewed journal
Statistical analysis plan    To be published in peer-reviewed journal
Informed consent form    Anticipated to be provided as supplementary materi... [More Details]
Ethical approval    DELIGHT_HRECApproval_InitialSubmission_20250820 (1).pdf


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.