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Neonatal outcomes in preterm multiples receiving delayed cord clamping.

Priya Jegatheesan1,2, Esther Belogolovsky1, Matthew Nudelman1

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Summary

Delayed cord clamping (DCC) in preterm infants showed comparable neonatal outcomes for singletons versus multiples. Outcomes were also similar between first-born and second-born multiples, and between monochorionic and dichorionic/trichorionic multiples.

Keywords:
delayed cord clampingmonochorionic multiplemultiplespretermsecond-born multiple

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Area of Science:

  • Neonatalogy
  • Perinatology
  • Obstetrics

Background:

  • Delayed cord clamping (DCC) is increasingly used in preterm infants.
  • Understanding neonatal outcomes in different infant groups receiving DCC is crucial.

Purpose of the Study:

  • To compare neonatal outcomes in singletons versus multiples.
  • To compare outcomes between first-born and second-born multiples.
  • To compare outcomes between monochorionic and dichorionic/trichorionic multiples, all <33 weeks gestational age receiving DCC.

Main Methods:

  • Retrospective, observational study of 529 preterm infants (<33 weeks GA) receiving DCC.
  • Statistical analysis using generalized estimating equations, mixed effects models, Wilcoxon signed-rank, and McNemar tests.
  • Comparison of outcomes between singletons and multiples, and within multiples subgroups.

Main Results:

  • Multiples had higher gestational age and caesarean section rates, but similar haematocrit levels after adjustment compared to singletons.
  • Second-born multiples were smaller and had lower survival without major morbidity compared to first-born multiples, though this was not significant after adjusting for birth weight.
  • Monochorionic multiples had slightly lower admission temperatures than dichorionic/trichorionic multiples, but this was not clinically significant.

Conclusions:

  • Neonatal outcomes were comparable between singletons and multiples receiving DCC.
  • Outcomes were also similar between first-born and second-born multiples.
  • No significant differences in neonatal outcomes were observed between monochorionic and dichorionic/trichorionic multiples.