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Early Hum Dev. 2018 Apr;119:15-18. doi: 10.1016/j.earlhumdev.2018.02.021. Epub 2018 Mar 5.

Effect of delay in cord clamping 45 versus 60 s on very preterm singleton infants.

Author information

1
Division of Neonatology, Department of Pediatrics, Baylor University Medical Center, Pediatrix Medical Group, Dallas, TX, USA. Electronic address: Arpitha.Chiruvolu@BSWHealth.org.
2
Department of Obstetrics and Gynecology, Baylor University Medical Center, Dallas, TX, USA.
3
Department of Nursing, Baylor University Medical Center, Dallas, TX, USA.
4
Department of Quantitative Health Sciences, Baylor Scott & White Health Care System, Dallas, TX, USA.

Abstract

BACKGROUND:

In the range of timing suggested by American College of Obstetricians and Gynecologists 30 to 60 s, preterm infants may potentially derive more short and long-term benefits with delayed cord clamping (DCC) for at least 60 s. However, there are concerns with longer resuscitation delay in this vulnerable population.

OBJECTIVE:

To compare the clinical consequences of 45 versus 60 s delay in umbilical cord clamping in singleton infants born between 230/7 to 316/7 weeks gestation.

STUDY DESIGN:

We implemented DCC process in very preterm singleton infants, initially for 45 s and later, modified the policy to increase the delay to 60 s. We compared the infants born and received DCC (n = 60) during the 45 s study period (DCC-45 cohort), from Aug.19, 2013, to Aug.18, 2014 to the infants born and received DCC (n = 63) during the 60 s study period (DCC-60 cohort), from Feb.1, 2015, to Jan.31, 2016.

RESULTS:

The incidence of necrotizing enterocolitis in DCC-60 cohort was 0% compared to 8% in the DCC-45 cohort (P = 0.02). Similarly, incidence of culture-positive sepsis was significantly lower in the DCC-60 cohort compared to DCC-45 cohort (8% versus 18%; P = 0.04). Incidence of mortality and other major morbidities were similar between both groups. Length of stay was significantly lower in DCC-60 cohort compared to DCC-45 cohort.

CONCLUSION:

DCC for 60 s in very preterm singleton infants was safe, feasible and not associated with any adverse maternal or neonatal short-term outcomes compared to DCC for 45 s.

KEYWORDS:

Delayed cord clamping; Placental transfusion; Quality improvement; Very preterm infants

[Indexed for MEDLINE]

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