Copmparion of the short term outcome of preterm infants with three different umbilical cord clamping methods

Abstract

The recommended method of handling the umbilical cord has been changed turn over last years and current knowledge and research has led the direction to delayed clamping and cord milking. There are various studies to identify the feasibility and safety of each techniques compared with conventional immediate clamping, but the final outcome is still controversial. The aim of this study was to compare the primary outcome of umbilical cord milking and delayed cord clamping compared with immediate cord clamping in preterm deliveries. Material and Method: In a single-center, prospective clinical trial, 90 preterm infants, born 28-32 weeks gestation (weight< 1500 g), were enrolled. Infants were randomly assigned in three equal groups (N= 30 in each) based on the clamping method at time of delivery. The primary outcomes were the admission hemoglobin, hemoglobin level within first month and at discharge, serum bilirubin level, rates of phototherapy, duration of hospitalization, need for blood transfusion and transfer, rates of oxygen ventilation, rates of bronchopulmonary dysplasia (BPD) and rates of intraventricular hemorrhage (IVH). Results: Demographic factors were similar between groups. Infants in cord milking group had a higher admission hemoglobin compared with immediate clamping (p<0.01) and higher hemoglobin level at one-month evaluation compared to each group. Cord clamping infant did not occur to have IVH, lower rate of need for oxygen ventilation, and reduced incidence of BPD compared with each group. The incidence of BPD and oxygen ventilation in delayed cord clamping infant were lower than immediate clamping group, while the rate of IVH was higher in among delayed clamping group when compared with immediate clamping. The rate of phototherapy was significantly higher in infants with cord milking compared to two other groups of infants.