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Premature infants receiving delayed cord clamping with and without cord milking: a randomized control trial

BACKGROUND: Preterm infants often have long hospital stays and frequent blood tests; they often develop anemia requiring multiple blood transfusions. Placental transfusion via delayed cord clamping (DCC) or umbilical cord milking (UCM) helps increase blood volume. We hypothesized umbilical cord milk...

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Autores principales: Prachukthum, Sariya, Tanprasertkul, Chamnan, Somprasit, Charintip
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10024362/
https://www.ncbi.nlm.nih.gov/pubmed/36932370
http://dx.doi.org/10.1186/s12887-023-03933-2
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author Prachukthum, Sariya
Tanprasertkul, Chamnan
Somprasit, Charintip
author_facet Prachukthum, Sariya
Tanprasertkul, Chamnan
Somprasit, Charintip
author_sort Prachukthum, Sariya
collection PubMed
description BACKGROUND: Preterm infants often have long hospital stays and frequent blood tests; they often develop anemia requiring multiple blood transfusions. Placental transfusion via delayed cord clamping (DCC) or umbilical cord milking (UCM) helps increase blood volume. We hypothesized umbilical cord milking (UCM), together with DCC, would be superior in reducing blood transfusions. OBJECTIVES: To compare the effects of DCC and DCC combined with UCM on hematologic outcomes among preterm infants. METHODS: One hundred twenty singleton preterm infants born at 280/7- 336/7 weeks of gestation at Thammasat University Hospital were enrolled in an open-label, randomized, controlled trial. They were placed into three groups (1:1:1) by a block-of-three randomization: DCC for 45 s, DCC with UCM performed before clamping (DCM-B), and DCC with UCM performed after clamping (DCM-A). The primary outcomes were hematocrit levels and number of infants receiving blood transfusions during the first 28 days of life. Intraventricular hemorrhage (IVH) and necrotizing enterocolitis (NEC) were secondary outcomes. Analyses were performed with an intent-to-treat approach. RESULTS: One hundred twenty preterm infants were randomized. There was no statistically significant difference in neonatal outcomes; hematocrit on admission 54.0 ± 5.5, 53.3 ± 6.0, and 54.3 ± 5.8 (p = 0.88), receiving blood transfusions 25%, 20%, and 12.5% (p = 0.24), incidence of NEC 7.5, 0 and 10% (p = 0.78) in the DCC, DCM-B and DCM-A groups, respectively. There were no preterm infants with severe IVH, polycythemia, maternal or neonatal death. CONCLUSION: The placental transfusion techniques utilized, DCC and DCC combined with UCM, provided the same benefits for preterm infants born at GA 28 and 33 weeks in terms of reducing the need for RBC transfusions, severities of IVH and incidence of NEC without increasing comorbidity. TRIAL REGISTRATION: TCTR20190131002. Registered 31 January 2019—Retrospectively registered.
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spelling pubmed-100243622023-03-19 Premature infants receiving delayed cord clamping with and without cord milking: a randomized control trial Prachukthum, Sariya Tanprasertkul, Chamnan Somprasit, Charintip BMC Pediatr Research Article BACKGROUND: Preterm infants often have long hospital stays and frequent blood tests; they often develop anemia requiring multiple blood transfusions. Placental transfusion via delayed cord clamping (DCC) or umbilical cord milking (UCM) helps increase blood volume. We hypothesized umbilical cord milking (UCM), together with DCC, would be superior in reducing blood transfusions. OBJECTIVES: To compare the effects of DCC and DCC combined with UCM on hematologic outcomes among preterm infants. METHODS: One hundred twenty singleton preterm infants born at 280/7- 336/7 weeks of gestation at Thammasat University Hospital were enrolled in an open-label, randomized, controlled trial. They were placed into three groups (1:1:1) by a block-of-three randomization: DCC for 45 s, DCC with UCM performed before clamping (DCM-B), and DCC with UCM performed after clamping (DCM-A). The primary outcomes were hematocrit levels and number of infants receiving blood transfusions during the first 28 days of life. Intraventricular hemorrhage (IVH) and necrotizing enterocolitis (NEC) were secondary outcomes. Analyses were performed with an intent-to-treat approach. RESULTS: One hundred twenty preterm infants were randomized. There was no statistically significant difference in neonatal outcomes; hematocrit on admission 54.0 ± 5.5, 53.3 ± 6.0, and 54.3 ± 5.8 (p = 0.88), receiving blood transfusions 25%, 20%, and 12.5% (p = 0.24), incidence of NEC 7.5, 0 and 10% (p = 0.78) in the DCC, DCM-B and DCM-A groups, respectively. There were no preterm infants with severe IVH, polycythemia, maternal or neonatal death. CONCLUSION: The placental transfusion techniques utilized, DCC and DCC combined with UCM, provided the same benefits for preterm infants born at GA 28 and 33 weeks in terms of reducing the need for RBC transfusions, severities of IVH and incidence of NEC without increasing comorbidity. TRIAL REGISTRATION: TCTR20190131002. Registered 31 January 2019—Retrospectively registered. BioMed Central 2023-03-18 /pmc/articles/PMC10024362/ /pubmed/36932370 http://dx.doi.org/10.1186/s12887-023-03933-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Prachukthum, Sariya
Tanprasertkul, Chamnan
Somprasit, Charintip
Premature infants receiving delayed cord clamping with and without cord milking: a randomized control trial
title Premature infants receiving delayed cord clamping with and without cord milking: a randomized control trial
title_full Premature infants receiving delayed cord clamping with and without cord milking: a randomized control trial
title_fullStr Premature infants receiving delayed cord clamping with and without cord milking: a randomized control trial
title_full_unstemmed Premature infants receiving delayed cord clamping with and without cord milking: a randomized control trial
title_short Premature infants receiving delayed cord clamping with and without cord milking: a randomized control trial
title_sort premature infants receiving delayed cord clamping with and without cord milking: a randomized control trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10024362/
https://www.ncbi.nlm.nih.gov/pubmed/36932370
http://dx.doi.org/10.1186/s12887-023-03933-2
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