Abstract
Objective
Intraventricular hemorrhage (IVH) is a common complication in extremely preterm infants. We aimed to demonstrate that umbilical cord milking (UCM) would reduce the incidence of IVH in this at risk population.
Study design
We compared the incidence of IVH in a prospective cohort of consecutively born preterm infants <32 weeks’ gestation receiving UCM (n = 33) with a historical cohort that underwent immediate cord clamping (ICC) (n = 36).
Results
No significant differences regarding perinatal characteristics were present between both groups except for chorioamnionitis and preterm rupture of membranes which were more frequent in the UCM group. There was a significant reduction in the incidence of IVH in the UCM group as compared to the ICC group (UCM vs. ICC = 12 vs. 33%, p = 0.037; OR = 0.276 (95% CI 0.079–0.967; p = 0.033; NNT = 4.7) and a reduction in the number of transfusions (UCM vs. ICC = 56 vs. 30%, p = 0.035; OR = 0.348 (0.129–0.938; p = 0.033; NNT = 3.8). UCM was safe for mothers (similar decrease in maternal hemoglobin) and offspring.
Conclusion
UCM significantly reduced the incidence of IVH in preterm infants < 32 weeks’ gestation without associated complications for mother or offspring.
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Acknowledgements
We would like to especially thank the families for their generosity in accepting participate in the study. We also would like to thank the obstetric team and the nursing staff in the delivery room for their essential contribution.
Funding
M Vento acknowledges a FIS PI17/0131 grant from the Instituto de Investigación Sanitaria Carlos III (Ministry of Science, Innovation and Universities; Kingdom of Spain)
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JDT conceived the study and contributed to its design, enrolled patients, retrieved and analyze the data, and wrote the draft of the manuscript. SR enrolled patients, retrieved and analyze the data, and wrote the draft of the manuscript. AP-I enrolled patients, retrieved and analyze the data, and wrote the draft of the manuscript, AD enrolled patients, retrieved and analyze the data, and wrote the draft of the manuscript, YM, enrolled patients, retrieved and analyze the data, and wrote the draft of the manuscript, MV contributed to the study design, supervised data analysis, and wrote the final version of the manuscript.
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Toledo, J.d., Rodilla, S., Pérez-Iranzo, A. et al. Umbilical cord milking reduces the risk of intraventricular hemorrhage in preterm infants born before 32 weeks of gestation. J Perinatol 39, 547–553 (2019). https://doi.org/10.1038/s41372-019-0329-6
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DOI: https://doi.org/10.1038/s41372-019-0329-6
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