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Placental transfusion in preterm neonates of 30–33 weeks’ gestation: a randomized controlled trial

Journal of Perinatology volume 38, pages 496–504 (2018)Cite this article

Subjects

Abstract

Objectives

To compare effect of placental transfusion by delayed cord clamping (DCC) or cord milking (CM) with early cord clamping (ECC) on a composite of mortality or abnormal neurological status at 40 weeks’ post-menstrual age (PMA) and 24–30 months’ chronological age in neonates of 30–33 weeks’ gestation.

Study design

Randomized, controlled trial.

Outcomes

A composite of mortality or abnormal neurological status at 40 weeks PMA and survival free of neurodevelopmental abnormalities at 24–30 months’ chronological age.

Results

A total of 461 neonates were randomized to placental transfusion (n = 233) or to ECC (n = 228). Among those assigned to placental transfusion group, 173 underwent DCC while in the remaining 60, CM was done. Incidence of mortality or abnormal neurological status at 40 weeks PMA (43 (18%) vs 35 (15%), RR (95% CI) 1.2 (0.8, 1.8), p = 0.4) and survival free of neurodevelopmental impairment at 24–30 months of chronological age (99 (47%) vs. 100 (50%); RR (95% CI): 0.9 (0.8, 1.2); P = 0.9) was similar between the study groups. The placental transfusion group showed a trend towards lower incidence of necrotizing enterocolitis.

Conclusion

In 30–33 weeks’ gestation preterm neonates, placental transfusion as compared to early cord clamping resulted in similar mortality or abnormal neurological status at 40 weeks PMA and at 24–30 months of chronological age.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India

    Bikramjit Das, Venkataseshan Sundaram & Praveen Kumar

  2. Department of Pediatrics, Apollo Gleneagles Hospital, Kolkata, India

    Bikramjit Das

  3. Perinatal Trials, WINNER Centre for Newborn Research, NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia

    William Tarnow-Mordi

  4. Australian Placental Transfusion Study, NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia

    Alpana Ghadge

  5. Department of Obstetrics & Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

    Lakhbir Kaur Dhaliwal

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  1. Bikramjit Das
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Correspondence to Venkataseshan Sundaram.

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Das, B., Sundaram, V., Tarnow-Mordi, W. et al. Placental transfusion in preterm neonates of 30–33 weeks’ gestation: a randomized controlled trial. J Perinatol 38, 496–504 (2018). https://doi.org/10.1038/s41372-018-0064-4

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