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Immediate compared with delayed cord clamping in the preterm neonate: a randomized controlled trial
Andrew Elimian1, Jean Goodman, Marilyn Escobedo
1Departments of Obstetrics and Gynecology and Pediatrics, University of Oklahoma Health Sciences Center, Williams Pavilion, Oklahoma City, Oklahoma.
Obstetrics and Gynecology
|November 22, 2014
Summary
Delayed umbilical cord clamping in preterm infants did not reduce the need for blood transfusions. However, it did lead to higher initial hemoglobin and hematocrit levels, with a trend towards fewer intraventricular hemorrhages.
Area of Science:
- Neonatal Medicine
- Perinatal Research
- Pediatric Critical Care
Background:
- The optimal timing for umbilical cord clamping in preterm neonates is not well-established.
- Early versus delayed clamping has potential implications for neonatal outcomes.
Purpose of the Study:
- To evaluate the short-term effects of delayed umbilical cord clamping in preterm neonates.
- To compare the need for blood transfusion between immediate and delayed cord clamping groups.
Main Methods:
- A randomized controlled trial was conducted involving preterm neonates (24-34 weeks gestation).
- Participants were randomized to either immediate or delayed cord clamping (30 seconds).
- The primary outcome was the requirement for blood transfusion.
Main Results:
- No significant difference was observed in the need for blood transfusion between the delayed (25.3%) and immediate (23.7%) cord clamping groups.
- Delayed clamping resulted in significantly higher initial hemoglobin and hematocrit levels.
- Rates of respiratory distress syndrome, periventricular leukomalacia, necrotizing enterocolitis, anemia of prematurity, and neonatal mortality did not differ significantly.
Conclusions:
- Delayed umbilical cord clamping for 30 seconds did not reduce the need for blood transfusion in preterm neonates.
- While not impacting transfusion rates, delayed clamping showed potential benefits in initial hematological parameters and a trend towards reduced intraventricular hemorrhage.
