The hematological impact of umbilical cord milking versus delayed cord clamping in premature neonates: a randomized controlled trial
Abstract Background The hematological impact of umbilical cord milking (UCM) was compared to that of delayed cord clamping (DCC) as a faster placental transfusion technique for preterm neonates (between 24 and 34 + 6 weeks gestation). A comparison of important neonatal morbidities was also made. Met...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-09-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-022-05046-7 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850111457314734080 |
|---|---|
| author | Hytham Atia Ahmed Badawie Osama Elsaid Mahmoud Kashef Nourhan Alhaddad Mohamed Gomaa |
| author_facet | Hytham Atia Ahmed Badawie Osama Elsaid Mahmoud Kashef Nourhan Alhaddad Mohamed Gomaa |
| author_sort | Hytham Atia |
| collection | DOAJ |
| description | Abstract Background The hematological impact of umbilical cord milking (UCM) was compared to that of delayed cord clamping (DCC) as a faster placental transfusion technique for preterm neonates (between 24 and 34 + 6 weeks gestation). A comparison of important neonatal morbidities was also made. Methods This was an open-label randomized trial conducted from June 8, 2017, to April 22, 2019. Two hundred patients with preterm deliveries (24 and 34 + 6 weeks gestation) were assigned to the DCC or UCM group at random at a ratio of 1:1. The study power was 80% for a difference in the hematocrit value of 3% and Hb value of one gram, and an alpha error of 0.05. Results The following variables were analyzed in the comparison of UCM vs. DCC: first draw hemoglobin: 17.0 ± 1.9 vs. 16.8 ± 1.8 gm/dl (95% CI -0.75–0.29, P 0.383); first draw hematocrit: 55.6 ± 6.4 vs. 55.2 ± 6.4% (95% CI -2.18–1.38, P 0.659); peak hematocrit: 56.9 ± 6.4 vs. 56.3 ± 6.7% (95% CI -2.41–1.26, P 0.537); the need for respiratory assistance (47% vs. 30%, P 0.020), inotropes (16% vs. 6%, P 0.040), and blood transfusion (26% vs. 12%, P 0.018); and the occurrence of intraventricular hemorrhage (9% vs. 5%, P 0.407), necrotizing enterocolitis (6% vs. 2%, P 0.279), sepsis (25% vs. 15%, P 0.111), and neonatal death (13% vs. 4%, P 0.40). Conclusion UCM facilitated a rapid transfer of placental blood equivalent to that of DCC for premature neonates. However, it resulted in increased rates of interventions and morbidities, especially in extremely preterm neonates. Trial registration The clinical trial was registered on May 10, 2017, with registration number (NCT03147846). |
| format | Article |
| id | doaj-art-cb084c81059942e9bfd568cacf35df87 |
| institution | OA Journals |
| issn | 1471-2393 |
| language | English |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-cb084c81059942e9bfd568cacf35df872025-08-20T02:37:36ZengBMCBMC Pregnancy and Childbirth1471-23932022-09-012211910.1186/s12884-022-05046-7The hematological impact of umbilical cord milking versus delayed cord clamping in premature neonates: a randomized controlled trialHytham Atia0Ahmed Badawie1Osama Elsaid2Mahmoud Kashef3Nourhan Alhaddad4Mohamed Gomaa5Faculty of Medicine, Zagazig UniversityArmed Forces Hospitals Southern Region, King Faisal Military City HospitalArmed Forces Hospitals Southern Region, King Faisal Military City HospitalArmed Forces Hospitals Southern Region, King Faisal Military City HospitalAl Ahmady HospitalArmed Forces Hospitals Southern Region, King Faisal Military City HospitalAbstract Background The hematological impact of umbilical cord milking (UCM) was compared to that of delayed cord clamping (DCC) as a faster placental transfusion technique for preterm neonates (between 24 and 34 + 6 weeks gestation). A comparison of important neonatal morbidities was also made. Methods This was an open-label randomized trial conducted from June 8, 2017, to April 22, 2019. Two hundred patients with preterm deliveries (24 and 34 + 6 weeks gestation) were assigned to the DCC or UCM group at random at a ratio of 1:1. The study power was 80% for a difference in the hematocrit value of 3% and Hb value of one gram, and an alpha error of 0.05. Results The following variables were analyzed in the comparison of UCM vs. DCC: first draw hemoglobin: 17.0 ± 1.9 vs. 16.8 ± 1.8 gm/dl (95% CI -0.75–0.29, P 0.383); first draw hematocrit: 55.6 ± 6.4 vs. 55.2 ± 6.4% (95% CI -2.18–1.38, P 0.659); peak hematocrit: 56.9 ± 6.4 vs. 56.3 ± 6.7% (95% CI -2.41–1.26, P 0.537); the need for respiratory assistance (47% vs. 30%, P 0.020), inotropes (16% vs. 6%, P 0.040), and blood transfusion (26% vs. 12%, P 0.018); and the occurrence of intraventricular hemorrhage (9% vs. 5%, P 0.407), necrotizing enterocolitis (6% vs. 2%, P 0.279), sepsis (25% vs. 15%, P 0.111), and neonatal death (13% vs. 4%, P 0.40). Conclusion UCM facilitated a rapid transfer of placental blood equivalent to that of DCC for premature neonates. However, it resulted in increased rates of interventions and morbidities, especially in extremely preterm neonates. Trial registration The clinical trial was registered on May 10, 2017, with registration number (NCT03147846).https://doi.org/10.1186/s12884-022-05046-7Cord milkingDeferred clampingHematocritPretermPlacental transfusion |
| spellingShingle | Hytham Atia Ahmed Badawie Osama Elsaid Mahmoud Kashef Nourhan Alhaddad Mohamed Gomaa The hematological impact of umbilical cord milking versus delayed cord clamping in premature neonates: a randomized controlled trial BMC Pregnancy and Childbirth Cord milking Deferred clamping Hematocrit Preterm Placental transfusion |
| title | The hematological impact of umbilical cord milking versus delayed cord clamping in premature neonates: a randomized controlled trial |
| title_full | The hematological impact of umbilical cord milking versus delayed cord clamping in premature neonates: a randomized controlled trial |
| title_fullStr | The hematological impact of umbilical cord milking versus delayed cord clamping in premature neonates: a randomized controlled trial |
| title_full_unstemmed | The hematological impact of umbilical cord milking versus delayed cord clamping in premature neonates: a randomized controlled trial |
| title_short | The hematological impact of umbilical cord milking versus delayed cord clamping in premature neonates: a randomized controlled trial |
| title_sort | hematological impact of umbilical cord milking versus delayed cord clamping in premature neonates a randomized controlled trial |
| topic | Cord milking Deferred clamping Hematocrit Preterm Placental transfusion |
| url | https://doi.org/10.1186/s12884-022-05046-7 |
| work_keys_str_mv | AT hythamatia thehematologicalimpactofumbilicalcordmilkingversusdelayedcordclampinginprematureneonatesarandomizedcontrolledtrial AT ahmedbadawie thehematologicalimpactofumbilicalcordmilkingversusdelayedcordclampinginprematureneonatesarandomizedcontrolledtrial AT osamaelsaid thehematologicalimpactofumbilicalcordmilkingversusdelayedcordclampinginprematureneonatesarandomizedcontrolledtrial AT mahmoudkashef thehematologicalimpactofumbilicalcordmilkingversusdelayedcordclampinginprematureneonatesarandomizedcontrolledtrial AT nourhanalhaddad thehematologicalimpactofumbilicalcordmilkingversusdelayedcordclampinginprematureneonatesarandomizedcontrolledtrial AT mohamedgomaa thehematologicalimpactofumbilicalcordmilkingversusdelayedcordclampinginprematureneonatesarandomizedcontrolledtrial AT hythamatia hematologicalimpactofumbilicalcordmilkingversusdelayedcordclampinginprematureneonatesarandomizedcontrolledtrial AT ahmedbadawie hematologicalimpactofumbilicalcordmilkingversusdelayedcordclampinginprematureneonatesarandomizedcontrolledtrial AT osamaelsaid hematologicalimpactofumbilicalcordmilkingversusdelayedcordclampinginprematureneonatesarandomizedcontrolledtrial AT mahmoudkashef hematologicalimpactofumbilicalcordmilkingversusdelayedcordclampinginprematureneonatesarandomizedcontrolledtrial AT nourhanalhaddad hematologicalimpactofumbilicalcordmilkingversusdelayedcordclampinginprematureneonatesarandomizedcontrolledtrial AT mohamedgomaa hematologicalimpactofumbilicalcordmilkingversusdelayedcordclampinginprematureneonatesarandomizedcontrolledtrial |