EFFECT OF DELAYED CORD CLAMPING VERSUS CORD MILKING IN PRETERM INFANTS: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background:Delayed cord clamping (DCC) is currently recommended for preterm infants to improve blood volume and decrease the rate of blood transfusion. Umbilical cord milking (CM) had similar advantages without interrupting neonatal resuscitation. However, the differences in neonatal outcomes between DCC and CM are not well elucidated. Objective:To compare neonatal outcomes between DCC and CM among preterm infants. Method:Infants born at 25-34 weeks of gestation were randomly allocated to one of two groups; group 1 received DCC for 60 seconds whereas group 2 received CM. Initial hemoglobin value was measured, while blood pressure and urine output were monitored. Neonatal complications and the rate of blood transfusion were recorded. Results: Twenty-two infants were enrolled in each group. No differences were observed regarding sex, gestational age, birth weight, mode of delivery, Apgar scores and rate of resuscitation between groups. The initial hemoglobin level of the DCC group [median 17.1 (13.1, 21.3) g/dL] did not differ from that of the CM group [median 17.1 (14.0, 22.5) g/dL], p=0.963. During the first 24 hours, no significant differences were observed regarding blood pressure and urine output between the groups. No differences were found in the rates of hypothermia, hyperbilirubinemia, intraventricular hemorrhage, necrotizing enterocolitis and rate of blood transfusion. Conclusion:We demonstrated no different effects on neonatal outcomes between DCC and CM among preterm infants. CM can be applied as an alternative to DCC especially in emergency situations. However, larger studies are warranted to determine the effects and safety of CM among preterm infants.