The impact of early versus delayed cord clamping on hematological and cardiovascular changes in preterm newborns between 24 and 34 weeks’ gestation: a randomized clinical trial

The impact of early versus delayed cord clamping on hematological and cardiovascular changes in preterm newborns between 24 and 34 weeks’ gestation: a randomized clinical trial

Purpose This study aimed to   investigate hematological and cardiac changes after early (ECC) versus delayed cord clamping (DCC) in preterm infants at 24–34 weeks of gestation. Methods Ninety-six healthy pregnant women were assigned randomly to the ECC (< 10 s postpartum, n  = 49) or DCC (45–60 s...

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Published in:Archives of gynecology and obstetrics Vol. 309; no. 6; pp. 2483 - 2490
Main Authors: García, Carolina, Prieto, María Teresa, Escudero, Fuensanta, Bosh-Giménez, Vicente, Quesada, Lorenzo, Lewanczyk, Monika, Pertegal, Miriam, Delgado, Juan Luis, Blanco-Carnero, Jose Eliseo, De Paco Matallana, Catalina
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-06-2024
Springer Nature B.V
Subjects:
Adult
Echocardiography
Endocrinology
Female
Gestational Age
Gynecology
Hematocrit
Hematology
Hemoglobin
Hemoglobins - analysis
Hemoglobins - metabolism
Human Genetics
Humans
Infant, Newborn
Infant, Premature - blood
Maternal-Fetal Medicine
Medicine
Medicine & Public Health
Obstetrics/Perinatology/Midwifery
Pregnancy
Time Factors
Umbilical Cord Clamping
Neonatal
Delayed cord clamping
Neonatal outcome
Ventilation
Early cord clamping
Surfactant
Preterm
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Summary:Purpose This study aimed to   investigate hematological and cardiac changes after early (ECC) versus delayed cord clamping (DCC) in preterm infants at 24–34 weeks of gestation. Methods Ninety-six healthy pregnant women were assigned randomly to the ECC (< 10 s postpartum, n  = 49) or DCC (45–60 s postpartum, n  = 47). Primary endpoint was evaluation of neonatal hemoglobin, hematocrit and bilirrubin levels within the first 7 days after birth. A postpartum blood test was performed in the mother and a neonatal echocardiography in the first week of life. Results We found differences in hematological parameters during the first week of life. On admission, the DCC group had higher hemoglobin levels than the ECC group (18.7 ± 3.0 vs. 16.8 ± 2.4, p  < 0.0014) and higher hematocrit values (53.9 ± 8.0 vs. 48.8 ± 6.4, p  < 0.0011). Around day 7 of life, hemoglobin levels were also higher in the DCC group compared with the ECC group (16.4 ± 3.8 vs 13.9 ± 2.5, p  < 0.005), as was the hematocrit (49.3 ± 12.7 vs 41.2 ± 8.4, p  < 0.0087). The need of transfusion was lower in the DCC compared to the ECC (8.5% vs 24.5%; OR: 0.29, 95% CI: 0.09–0.97, p  < 0.036). The need for phototherapy was also higher in the DCC (80.9% vs 63.3%; OR: 0.23, 95% CI: 0.06–0.84, p  < 0.026). No differences in cardiac parameters or maternal blood tests. Conclusion DCC improved neonatal hematological parameters. No changes in cardiac function were found and maternal blood loss did not increase to require transfusion.
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ISSN:1432-0711
0932-0067
1432-0711
DOI:10.1007/s00404-023-07119-0