Immediate versus Delayed Umbilical Cord Clamping in Premature Neonates Born < 35 Weeks: A Prospective, Randomized, Controlled Study

Amir Kugelman; Liron Borenstein-Levin; Arieh Riskin; Irena Chistyakov; Gonen Ohel; Ron Gonen; David Bader

doi:10.1055/s-2007-981434

American Journal of Perinatology, Table of Contents

Am J Perinatol 2007; 24(5): 307-315
DOI: 10.1055/s-2007-981434

Immediate versus Delayed Umbilical Cord Clamping in Premature Neonates Born < 35 Weeks: A Prospective, Randomized, Controlled Study

Amir Kugelman¹ , Liron Borenstein-Levin¹ , Arieh Riskin¹ , Irena Chistyakov¹ , Gonen Ohel² , Ron Gonen² , David Bader¹

¹Department of Neonatology, Bnai-Zion Medical Center, The Bruce Rappaport Faculty of Medicine, Haifa, Israel
²Department of Obstetrics and Gynecology, Bnai-Zion Medical Center, The Bruce Rappaport Faculty of Medicine, Haifa, Israel

Abstract

ABSTRACT

The purpose of this study was to test whether delayed versus immediate cord clamping would result in higher blood pressure (BP) and hematocrit (Hct), and to assess its clinical effects on the neonatal course in premature neonates (< 35 weeks). This was a prospective, masked, randomized, controlled study. Prior to delivery, 35 neonates were randomly assigned to immediate cord clamping (ICC) at 5 to 10 seconds, and a comparable group of 30 neonates were randomly assigned to delayed cord clamping (DCC) at 30 to 45 seconds. Intention-to-treat analyses revealed that the DCC group tended to have higher initial diastolic BP and higher Hct (especially in vaginally delivered neonates). Infants weighing < 1500 g with DCC tended to have higher mean BP, and needed less mechanical ventilation and surfactant compared with ICC neonates. Infants with DCC did not experience more polycythemia (Hct > 60%), but had a trend toward higher bilirubin levels with no differences in the phototherapy needs. DCC seems to be safe and may be beneficial when compared with ICC in premature neonates. However, the differences between the two methods were modest and the clinical relevance needs to be assessed further by larger studies and additional meta-analysis of randomized trials.

KEYWORDS

Immediate cord clamping - delayed cord clamping - premature neonates

Full Text

References

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Amir KugelmanM.D.

Department of Neonatology, Bnai-Zion Medical Center

47 Golomb Street, Haifa, 31048, Israel