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Physiological-based cord clamping stabilised cardiorespiratory parameters in very low birth weight infants
Nina Hoeller1, Christina Helene Wolfsberger1, Ernst Prethaler1
1Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
Insights
Physiological-based cord clamping (PBCC) stabilized cardiorespiratory parameters in very low birth weight (VLBW) infants. This method resulted in a lower heart rate, suggesting improved blood volume during initial resuscitation.
Area of Science:
- Neonatal Medicine
- Perinatal Physiology
- Pediatric Cardiology
Background:
- Very low birth weight (VLBW) infants are susceptible to cardiorespiratory instability.
- Optimal timing and methods of umbilical cord clamping are critical for neonatal adaptation.
- Physiological-based cord clamping (PBCC) aims to optimize placental transfusion and physiological stability.
Purpose of the Study:
- To investigate the impact of physiological-based cord clamping (PBCC) on cardiorespiratory stability in VLBW infants.
- To compare cardiorespiratory parameters in VLBW infants managed with PBCC versus delayed cord clamping.
- To assess the influence of PBCC on heart rate and other physiological markers in the first 72 hours of life.
Main Methods:
- Retrospective study of VLBW infants (<32 weeks gestation).
- Matching of PBCC infants with delayed cord clamping controls based on gestational age and birth weight.
- Comparison of routine monitoring parameters, including heart rate, between the two groups.
Main Results:
- Fifty-four VLBW infants were included in the analysis.
- No significant differences in gestational age or birth weight between PBCC and control groups.
- PBCC group exhibited a significantly lower heart rate during the first 72 hours, particularly by 10 hours post-birth.
Conclusions:
- Physiological-based cord clamping (PBCC) demonstrates a stabilizing effect on cardiorespiratory parameters in VLBW infants.
- The observed lower heart rate in the PBCC group suggests enhanced blood volume and improved circulatory adaptation.
- PBCC may be a beneficial intervention for improving neonatal outcomes in VLBW infants.
Aim:
We investigated the influence of physiological-based cord clamping (PBCC) on cardiorespiratory stability in very low birth weight (VLBW) infants during the first 72 h of life.
Methods:
This retrospective study comprised VLBW infants born at <32 + 0 weeks of gestation and admitted to the neonatal intensive care unit of the Medical University of Graz, Austria, from December 2014 to April 2021. VLBW infants delivered with PBCC were matched by gestational age and birth weight to delayed cord clamping controls. The PBCC group was stabilised after birth with an intact cord. Routine monitoring parameters were compared between the groups.
Results:
We included 54 VLBW infants. The mean gestational ages of the PBCC group and controls were 27.4 ± 1.9 versus 27.4 ± 1.8 weeks (p = 0.87), and the mean birth weights were 912 ± 288 versus 915 ± 285 g (p = 0.96), respectively. The mean cord clamping time was 191 ± 78 s in the PBCC group. Heart rate was lower in the PBCC group during the first 3 days after birth, reaching significance by 10 h. Other monitoring parameters did not reveal any differences between the two groups.
Conclusion:
PBCC stabilised cardiorespiratory parameters in VLBW infants. The lower heart rate in the PBCC group suggested higher blood volume following intact cord resuscitation.
