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The purpose of the CHAPTER study is to help understand how complications during pregnancy, such as preterm birth, affect how childrens’ hearts and blood vessels develop.


Study Background

Worldwide, approximately 1 in 10 infants are born preterm (less than 37 weeks gestation). As the number of preterm-born survivors continues to rise with advances in clinical care, the impact on heart and blood vessel structure and function is relevant to a growing proportion of the population.

Study Objectives

We know that complications during pregnancy, such as preterm birth, may affect the way a child’s heart and blood vessels develop. This project will help us understand more about why this occurs, using methods including ultrasound imaging and magnetic resonance imaging of childrens’ hearts, as well as blood pressure measurements to see how their blood vessels work.

Study Recruitment

We are asking children aged 3-12 years old born preterm or term (37-42 weeks’ gestation), who were delivered at, or admitted to, the Oxford University Hospitals NHS Foundation Trust, and who took part in the EPOCH research study as a baby, to take part.

Study Visits

There are two study visits as part of the CHAPTER study, which will take place at the Oxford Cardiovascular Clinical Research Facility (CCRF) at the John Radcliffe Hospital in Oxford. One of the visits is a longer visit, lasting up to 3 hours, while the other will last up to 1.5 hours. These visits will be 2 to 4 years apart.

The longer visit will be done on children between the ages of 6-8 years inclusive, and will include an MRI scan and echocardiography (ultrasound) to take pictures of the heart, lung function assessment (spirometry), recordings of blood pressure, as well as retinal microvascular imaging (collecting images of the small blood vessels in the back of the eye), and optional blood sampling. During this visit, we will also collect demographic and anthropometric data, and parents/guardians will be asked to complete a questionnaire. The study visit will finish with children being provided with a wrist worn activity tracker to wear for 7 days.

The shorter visit will be done on all children between ages 3-5 years inclusive or 9-12 years inclusive and will include an echocardiography scan of the heart, blood pressure measurements, demographic and anthropometric data collection, a questionnaire, as well as wrist-worn activity monitoring.

Research Funding

The study is supported with funding from the British Heart Foundation as part of Dr Lewandowski’s BHF Intermediate Research Fellowship  (FS/18/3/33292).

Study Approvals

The study has been approved by the West Midlands – Black Country Research Ethics Committee (Reference 18/WM/0131).

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