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Optimizing cord management for each preterm baby - Challenges of collating individual participant data and
Anna Lene Seidler1, Kylie E Hunter2, Angie Barba3
1Senior Research Fellow, NHMRC Clinical Trials Centre, University of Sydney, Australia.
Insights
Optimal cord management for preterm infants remains unclear. The iCOMP Collaboration pooled data from over 100 trials to provide recommendations for future research and improve neonatal outcomes.
Area of Science:
- Neonatal Research
- Perinatology
- Evidence Synthesis
Background:
- Optimal cord management strategies for preterm infants are not definitively established.
- Over 100 randomized controlled trials (RCTs) have investigated this question without reaching a consensus.
Purpose of the Study:
- To conduct an individual participant data network meta-analysis of RCTs on cord management at preterm birth.
- To describe challenges in data acquisition for cord management research.
- To derive recommendations for future collaborative research in perinatology.
Main Methods:
- Individual participant data network meta-analysis of existing RCTs.
- Data harmonization and synthesis from multiple international studies.
- Qualitative description of data acquisition challenges.
Main Results:
- The iCOMP (individual participant data on COrd Management at Preterm birth) Collaboration successfully pooled data from numerous RCTs.
- Key challenges and best practices for collaborative data acquisition were identified.
- Recommendations for future research protocols and reporting standards were derived.
Conclusions:
- Collaborative research, exemplified by the iCOMP Collaboration, is crucial for resolving controversies in neonatal care.
- Standardized protocols, quality assurance, and focus on vulnerable populations are essential for future perinatology research.
- Improved research methodologies can lead to better neonatal outcomes worldwide.
Abstract:
The optimal cord management strategy at birth for each preterm baby is still unknown, despite more than 100 randomized controlled trials (RCTs) undertaken on this question. To address this, we brought together all RCTs examining cord management strategies at preterm birth in the iCOMP (individual participant data on COrd Management at Preterm birth) Collaboration, to perform an individual participant data network meta-analysis. In this paper, we describe the trials and tribulations around obtaining individual participant data to resolve controversies around cord clamping, and we derive key recommendations for future collaborative research in perinatology. To reliably answer outstanding questions, future cord management research needs to be collaborative and coordinated, by aligning core protocol elements, ensuring quality and reporting standards are met, and carefully considering and reporting on vulnerable sub-populations. The iCOMP Collaboration is an example of the power of collaboration to address priority research questions, and ultimately improve neonatal outcomes worldwide.
