Deferred Cord Clamping in Very Preterm Triplets and Outcomes: A Retrospective Cohort Study
Prakesh S Shah1,2, Yi-Chen Su3, Walid El-Naggar4
1Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada, prakeshkumar.shah@sinaihealth.ca.
Neonatology
|December 18, 2025
Summary
Deferred cord clamping (DCC) in very preterm triplets born before 33 weeks gestation showed no significant benefits or harms. This study analyzed outcomes in Canadian neonatal intensive care units (NICUs), finding no association with survival or neurological injury.
Area of Science:
- Neonatal Medicine
- Perinatal Research
- Maternal-Fetal Medicine
Background:
- Limited data exists on the benefits and harms of deferred cord clamping (DCC) in triplets.
- The study focuses on very preterm infants (gestational age <33 weeks) admitted to Canadian NICUs.
Purpose of the Study:
- To compare outcomes of triplets following exposure to DCC.
- To investigate the association between DCC and neonatal survival, neurological injury, and late-onset sepsis.
Main Methods:
- Retrospective, population-representative cohort study of triplets born before 33 weeks' gestation in Canadian NICUs.
- DCC defined as cord clamping after 30 seconds.
- Target trial emulation technique used to analyze data, accounting for correlated outcomes within triplet sets.
Main Results:
- Out of 226 triplet sets, 376 neonates received DCC and 302 did not.
- No association found between DCC and survival, neurological injury, or late-onset sepsis.
- Neonates not receiving DCC showed higher inotrope use and longer hospital stays.
Conclusions:
- Deferred cord clamping (DCC) is not associated with benefit or harm in very preterm triplets.
- Further research may be needed to explore specific subgroups or alternative interventions.
