Longer Duration of Cord Clamping Improves Nicu Survival Without Major Morbidities in Very Preterm Infants
Background: Longer duration of deferred cord clamping (DCC), at least 120 s, is associated with the highest reduction in mortality compared to shorter durations of DCC or immediate cord clamping in preterm infants. We compared the neonatal outcomes of very preterm infants who received at least 60 s...
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MDPI AG
2024-12-01
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| Online Access: | https://www.mdpi.com/2227-9067/11/12/1546 |
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| author | Priya Jegatheesan Esther Belogolovsky Matthew Nudelman Sudha Rani Narasimhan Angela Huang Balaji Govindaswami Dongli Song |
| author_facet | Priya Jegatheesan Esther Belogolovsky Matthew Nudelman Sudha Rani Narasimhan Angela Huang Balaji Govindaswami Dongli Song |
| author_sort | Priya Jegatheesan |
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| description | Background: Longer duration of deferred cord clamping (DCC), at least 120 s, is associated with the highest reduction in mortality compared to shorter durations of DCC or immediate cord clamping in preterm infants. We compared the neonatal outcomes of very preterm infants who received at least 60 s to those who received at least 120 s of DCC. Methods: This is a retrospective single-center study including preterm infants born <33 weeks of gestational age (GA) between 2014 and 2019. The intended duration of DCC was 60 s in Period 1 (January 2014 to June 2016, <i>n</i> = 139) and 120 to 180 s in Period 2 (July 2016 to December 2019, <i>n</i> = 155). We compared the demographics, delivery room measures, and neonatal outcomes between the two periods as intent-to-treat analysis and per protocol analysis. Results: The intended duration of DCC was completed in 75% of infants in Period 1 (<i>n</i> = 106) and 76% of infants in Period 2 (<i>n</i> = 114). There was an increase in survival without major morbidities in the infants that received at least 120 s of DCC, which remained significant after adjusting for GA and erythropoietin use (Odds ratio 8.6, 95% CI 1.6 to 45.7). Conclusions: Longer duration of DCC is associated with improved survival without major morbidities in preterm infants <33 weeks GA. |
| format | Article |
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| institution | DOAJ |
| issn | 2227-9067 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
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| spelling | doaj-art-7147be64375b44389c1002fcc4ef542e2025-08-20T02:53:25ZengMDPI AGChildren2227-90672024-12-011112154610.3390/children11121546Longer Duration of Cord Clamping Improves Nicu Survival Without Major Morbidities in Very Preterm InfantsPriya Jegatheesan0Esther Belogolovsky1Matthew Nudelman2Sudha Rani Narasimhan3Angela Huang4Balaji Govindaswami5Dongli Song6Division of Neonatology, Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, CA 95128, USADepartment of Pediatrics, School of Medicine, Stanford University, Stanford, CA 94305, USASchool of Medicine and Public Health, Department of Medicine and Clinical Informatics, University of Wisconsin Hospital and Clinics, Madison, WI 53210, USADivision of Neonatology, Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, CA 95128, USADivision of Neonatology, Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, CA 95128, USADivision of Neonatology, Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, CA 95128, USADivision of Neonatology, Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, CA 95128, USABackground: Longer duration of deferred cord clamping (DCC), at least 120 s, is associated with the highest reduction in mortality compared to shorter durations of DCC or immediate cord clamping in preterm infants. We compared the neonatal outcomes of very preterm infants who received at least 60 s to those who received at least 120 s of DCC. Methods: This is a retrospective single-center study including preterm infants born <33 weeks of gestational age (GA) between 2014 and 2019. The intended duration of DCC was 60 s in Period 1 (January 2014 to June 2016, <i>n</i> = 139) and 120 to 180 s in Period 2 (July 2016 to December 2019, <i>n</i> = 155). We compared the demographics, delivery room measures, and neonatal outcomes between the two periods as intent-to-treat analysis and per protocol analysis. Results: The intended duration of DCC was completed in 75% of infants in Period 1 (<i>n</i> = 106) and 76% of infants in Period 2 (<i>n</i> = 114). There was an increase in survival without major morbidities in the infants that received at least 120 s of DCC, which remained significant after adjusting for GA and erythropoietin use (Odds ratio 8.6, 95% CI 1.6 to 45.7). Conclusions: Longer duration of DCC is associated with improved survival without major morbidities in preterm infants <33 weeks GA.https://www.mdpi.com/2227-9067/11/12/1546delayed cord clampingdeferred cord clampingduration of cord clampingumbilical cord managementvery preterm infantspreterm infant outcomes |
| spellingShingle | Priya Jegatheesan Esther Belogolovsky Matthew Nudelman Sudha Rani Narasimhan Angela Huang Balaji Govindaswami Dongli Song Longer Duration of Cord Clamping Improves Nicu Survival Without Major Morbidities in Very Preterm Infants Children delayed cord clamping deferred cord clamping duration of cord clamping umbilical cord management very preterm infants preterm infant outcomes |
| title | Longer Duration of Cord Clamping Improves Nicu Survival Without Major Morbidities in Very Preterm Infants |
| title_full | Longer Duration of Cord Clamping Improves Nicu Survival Without Major Morbidities in Very Preterm Infants |
| title_fullStr | Longer Duration of Cord Clamping Improves Nicu Survival Without Major Morbidities in Very Preterm Infants |
| title_full_unstemmed | Longer Duration of Cord Clamping Improves Nicu Survival Without Major Morbidities in Very Preterm Infants |
| title_short | Longer Duration of Cord Clamping Improves Nicu Survival Without Major Morbidities in Very Preterm Infants |
| title_sort | longer duration of cord clamping improves nicu survival without major morbidities in very preterm infants |
| topic | delayed cord clamping deferred cord clamping duration of cord clamping umbilical cord management very preterm infants preterm infant outcomes |
| url | https://www.mdpi.com/2227-9067/11/12/1546 |
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