Umbilical Cord Management in Late Preterm and Term Infants: A Randomized Controlled Trial

Area of Science:

• Neonatal Medicine
• Pediatric Hematology
• Obstetrics

Background:

• Umbilical cord management is crucial for neonatal adaptation.
• Different methods exist, including immediate cord clamping and cord milking.
• The distinct effects of intact-umbilical cord milking (I-UCM), cut-umbilical cord milking (C-UCM), and immediate cord clamping (ICC) require clarification.

Purpose of the Study:

• To compare the hematological outcomes of three umbilical cord management techniques in term and late-preterm infants.
• To evaluate the impact of I-UCM, C-UCM, and ICC on neonatal hematological parameters.

Main Methods:

• A randomized controlled trial involving 587 neonates born after 35 weeks' gestation.
• Infants were allocated to I-UCM (n=197), C-UCM (n=190), or ICC (n=200) groups.
• Hematological parameters, including hemoglobin and hematocrit, were assessed at 48 hours of age.

Main Results:

• Infants in the I-UCM group exhibited significantly higher mean hemoglobin levels compared to the ICC group (p=0.002).
• Mean hematocrit levels were also significantly higher in the I-UCM group versus the ICC group (p=0.010).
• This study is the first to concurrently compare I-UCM, C-UCM, and ICC.

Conclusions:

• Intact-umbilical cord milking (I-UCM) appears to be a more beneficial method for umbilical cord management regarding hematological parameters.
• Further research is warranted to fully understand the short- and long-term implications of various cord milking techniques.
• Distinguishing between I-UCM and C-UCM is important as they represent different procedures.