Delayed versus immediate cord clamping in dichorionic twins <32 weeks: a retrospective study

Area of Science:

• Neonatal Medicine
• Perinatal Research
• Maternal-Fetal Medicine

Background:

• Delayed cord clamping (DCC) is beneficial for singleton neonates.
• Limited data exist on DCC safety and efficacy in twins, especially preterm infants.
• Guidelines lack recommendations for DCC in twin gestations.

Purpose of the Study:

• To evaluate the effects of DCC on dichorionic twins born before 32 weeks of gestation.
• To compare neonatal and maternal outcomes between DCC and immediate cord clamping (ICC).

Main Methods:

• Retrospective cohort study design.
• Comparison of outcomes between DCC (60 seconds) and ICC (<15 seconds).
• Generalized estimating equations used to account for twin correlation.

Main Results:

• No significant difference in death before discharge between DCC and ICC groups.
• DCC associated with increased neonatal hemoglobin levels at 12-24 hours of life.
• Higher estimated maternal blood loss observed in the DCC group for cesarean deliveries (p=0.005).

Conclusions:

• DCC for 60 seconds in preterm dichorionic twins is linked to higher neonatal hemoglobin levels.
• Increased maternal blood loss in cesarean sections with DCC necessitates further investigation into maternal safety.
• Further trials are needed to fully assess the maternal safety of DCC in this population.