Deferred Cord Clamping and Weight Difference for Very Preterm Infants

Area of Science:

• Neonatal Medicine
• Perinatal Research
• Pediatric Critical Care

Background:

• Deferred cord clamping (DCC) is a practice aimed at improving neonatal outcomes.
• Its effect on initial weight in very preterm infants (<32 weeks gestational age) requires further real-world data.

Purpose of the Study:

• To determine the association between DCC and first-recorded weight in very preterm infants.
• To analyze real-world data from a large cohort of neonatal intensive care unit (NICU) admissions.

Main Methods:

• Retrospective cohort study using data from 138 California hospitals (2016-2023).
• Included infants between 22 and 31 weeks gestational age, excluding cord milking, delivery room deaths, or missing data.
• Linear regression analysis adjusted for gestational age and intrauterine growth restriction (IUGR).

Main Results:

• Analysis included 32,634 very preterm infants.
• Deferred cord clamping (DCC) was associated with a 24g higher first-recorded weight (95% CI: 18-29g).
• Mean weight was 1,338g with DCC versus 1,290g without.

Conclusions:

• A minimum of 30 seconds of DCC is associated with a modest increase in first-recorded weight for very preterm infants.
• This finding supports previous clinical trial evidence suggesting DCC increases blood volume and weight gain.
• Real-world data confirms the benefits of DCC in a large, diverse population.