502: The DUC trial: a pilot randomized controlled trial of immediate vs. delayed umbilical cord clamping in preterm infants born between 24 and 32 weeks gestation

2011 ◽  
Vol 204 (1) ◽  
pp. S201 ◽  
Author(s):  
Kelly Chu ◽  
Wendy Whittle ◽  
Rory Windrim ◽  
Prakeshkumar Shah ◽  
Kellie Murphy
Neonatology ◽  
2018 ◽  
Vol 115 (2) ◽  
pp. 156-163 ◽  
Author(s):  
Chayatat Ruangkit ◽  
Sommart Bumrungphuet ◽  
Panyu Panburana ◽  
Anant Khositseth ◽  
Pracha Nuntnarumit

Author(s):  
Justin B. Josephsen ◽  
Shannon Potter ◽  
Eric S. Armbrecht ◽  
Mohamad Al-Hosni

Objective This study aimed to assess potential benefits of umbilical cord milking (UCM) when compared with immediate cord clamping (ICC) in extremely preterm infants. Study Design This is a single-center, randomized controlled trial of infants 240/7 to 276/7 weeks' gestation who received UCM versus ICC. In the experimental group, 18 cm of the umbilical cord was milked three times. The primary aim was to assess the initial hemoglobin and to assess the number of blood transfusions received in the first 28 days after birth. Secondary outcomes were also assessed, including intraventricular hemorrhage (IVH). A priori, neurodevelopmental follow-up was planned at 15 to 18 months corrected gestational age (CGA). Results Baseline characteristics for 56 enrolled infants were similar in both groups with a mean gestational age of 26.1 ± 1.2 weeks and a mean birth weight of 815 ± 204 g. There were no differences in the mean initial hemoglobin in the UCM group when compared with the ICC group, 13.7 ± 2.0 and 13.8 ± 2.6 g/dL, respectively (p = 0.95), with no differences in median number of blood transfusions after birth between the ICC group and the UCM group, 2 (interquartile range [IQR]: 1–4) versus 2.5 (IQR: 1–5) (p = 0.40). There was also no difference in the rate of severe IVH. At 15 to 18 months CGA, there were no differences in death or disability in the ICC group compared with the UCM group (26 vs. 22%; p = 1.0) and no differences in neurodevelopmental outcomes. Conclusion In a randomized trial of ICC versus UCM in extremely preterm infants, no differences were seen in initial hemoglobin or number of blood transfusions. Key Points


Author(s):  
Sevil Güner ◽  
Birsen Karaca Saydam

Background: Anemia during infancy causes irreversible physical, cognitive, motor, and behavioral development disorders. This study aimed to determine the effect of delaying umbilical cord clamping time on certain parameters regarding anemia during the infancy. Methods: This randomized controlled trial was conducted at a university hospital in west of Turkey (Dec 2017- Dec 2018). Overall, 110 participants were evaluated for the research, 65 participants were randomized after excluding those who did not meet the inclusion criteria (intervention=32, control=33). Randomly assigned to delayed clamping (1 min after delivery) or early clamping (in 15 sec after delivery), and followed up until 4 months postpartum. 48th-hour hematocrit, bilirubin values, need for phototherapy and hematocrit, hemoglobin values, diagnosis of anemia at the postnatal fourth month were compared between two groups. The data showing normal distribution were assessed using the parametric tests. The level of statistical significance was determined as P<0.05. Results: The 48th-hour hematocrit and bilirubin levels of the intervention group were significantly higher than the control (P<0.01 and P<0.05, respectively). No significant difference regarding the need for phototherapy due to postnatal hyperbilirubinemia was observed between the two groups (P>0.05). Means of the intervention group hematocrit and hemoglobin levels measured during anemia screening performed at the fourth month were found to be higher than those of the infants in the control group (P<0.05 and P<0.05, respectively). Conclusion: Delaying umbilical cord clamping had a positive impact on the haematological parameters of infants. Clamping the cord at least one minute in birth can be performed to prevent the iron deficit anemia that could be seen during the first years of infants’ lives.


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