Clinical Research Directory

Cadmium Exposure During Pregnancy and Fetal Growth

Cadmium is a toxic heavy metal naturally present in the environment, whose human exposure has increased over recent decades due to diffuse anthropogenic contamination, particularly related to industrial activities and the use of mineral phosphate fertilizers in agriculture. Cadmium is characterized by its bioaccumulative properties and well-established toxicity, including renal and bone damage and carcinogenic effects. In pregnant women, several animal and human cohort studies have shown that cadmium can cross the placental barrier and accumulate in placental tissue. Placental cadmium exposure has been associated with impaired placental function and adverse perinatal outcomes, including fetal growth restriction and increased neonatal morbidity. In the general population without occupational exposure, diet represents the main source of cadmium exposure, apart from tobacco smoking. Fetal growth, commonly assessed through birth weight adjusted for gestational age, is a major determinant of neonatal and long-term health outcomes. This monocentric prospective pilot study aims to assess fetal exposure to cadmium during pregnancy using placental cadmium concentration as a biomarker. Placental samples will be collected at delivery from women giving birth at Amiens University Hospital, and cadmium levels will be measured using inductively coupled plasma mass spectrometry. The association between placental cadmium concentration and fetal growth will be explored. Fetal growth will be evaluated using birth weight adjusted for gestational age, expressed as a standardized z-score. Maternal urinary and blood cadmium concentrations will also be measured to characterize maternal exposure and explore correlations between biological matrices. Placental efficiency, defined as the fetal-to-placental weight ratio, will be assessed as an indicator of placental function. The results of this pilot study will provide preliminary data to inform future larger-scale epidemiological and mechanistic studies on prenatal cadmium exposure and pregnancy outcomes.

Clinicians' Trust in AI-Based Fetal Growth Estimates

This study examines how clinicians trust and use artificial intelligence (AI) when estimating fetal weight during pregnancy. Accurate assessment of fetal growth is important for identifying growth problems that may affect pregnancy management. New AI-based tools can estimate fetal weight from ultrasound images, but little is known about how clinicians trust these estimates or how uncertainty information influences their decisions. In this study, clinicians will review anonymized ultrasound cases and compare fetal weight estimates generated by an AI model with traditional estimates. Some clinicians will also be shown information about the AI model's performance and uncertainty, while others will not. Participants will be asked to choose which estimate they find most reliable, indicate their level of confidence, and decide whether they would recommend follow-up scans. The study aims to better understand how AI and uncertainty information affect clinical decision-making and trust among clinicians with different levels of experience.