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Delayed cord clamping in small for gestational age preterm infants
Beth Ellen Brown1, Prakesh S Shah2, Jehier K Afifi1
1Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
American Journal of Obstetrics and Gynecology
|August 13, 2021
Summary
Delayed cord clamping for small for gestational age preterm infants significantly reduced mortality or major morbidity. These benefits mirrored those observed in non-small for gestational age preterm infants, highlighting its potential clinical value.
Area of Science:
- Neonatal Medicine
- Perinatal Research
- Obstetrics
Background:
- Infants with restricted growth are prone to complications due to poor placental circulation.
- Delayed cord clamping (DCC) is a potential intervention for these vulnerable infants.
Purpose of the Study:
- To compare neonatal outcomes of DCC versus early cord clamping (ECC) in small for gestational age (SGA) preterm infants.
- To determine if DCC effects in SGA preterm infants differ from non-SGA preterm infants.
Main Methods:
- National retrospective cohort study of preterm infants (<33 weeks gestation) from 2015-2017.
- Compared DCC (≥30 seconds) versus ECC in SGA (<10th percentile) and non-SGA infants.
- Analyzed composite mortality/major morbidity, bilirubin levels, and blood transfusions using GEE regression models.
Main Results:
- DCC in SGA infants was linked to reduced mortality or major morbidity (aOR 0.60; 95% CI 0.42-0.86) compared to ECC.
- No significant difference in peak serum bilirubin between DCC and ECC groups.
- Benefits of DCC in SGA infants were comparable to those in non-SGA infants.
Conclusions:
- Delayed cord clamping in SGA preterm infants is associated with lower odds of mortality or major morbidity.
- The positive effects of DCC in SGA preterm infants align with findings in non-SGA preterm infants.
