Deferred Cord Clamping With High Oxygen in Extremely Preterm Infants: A Randomized Clinical Trial

Area of Science:

• Neonatal Medicine
• Pediatric Resuscitation
• Perinatal Research

Background:

• Deferred cord clamping (DCC) is a practice that may help reduce early hypoxia in preterm newborns.
• The safety and efficacy of using high oxygen concentrations during DCC have not been previously studied.

Purpose of the Study:

• To evaluate if administering 100% oxygen during DCC in preterm infants reduces hypoxemia compared to 30% oxygen.
• To assess the impact of high oxygen during DCC on early oxygen saturation levels in neonates.

Main Methods:

• A double-blinded randomized clinical trial involving 140 preterm infants (22-28 weeks' gestation).
• Infants received either 30% or 100% oxygen via face mask during DCC.
• The primary outcome measured was the achievement of peripheral oxygen saturation of 80% by 5 minutes of life.

Main Results:

• Infants receiving 100% oxygen during DCC were more likely to achieve 80% oxygen saturation by 5 minutes (69% vs. 39%).
• The high oxygen group had a 30% lower risk of hypoxemia at 5 minutes post-birth.
• No significant differences were observed in severe intraventricular hemorrhage or mortality between groups.

Conclusions:

• Administering 100% oxygen during DCC effectively reduces early hypoxemia in preterm infants without increasing immediate morbidity.
• Further large-scale randomized trials are warranted to confirm benefits on survival and long-term outcomes.