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Umbilical cord milking in preterm infants: time to act

Journal of Perinatology volume 39, pages 889–890 (2019)Cite this article

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Research on the efficacy and safety of umbilical cord milking (UCM) in preterm infants is the need of the hour and this study [1] is an effort in this direction. However, the concerns of International Liaison Committee on Resuscitation (ILCOR) 2015 on UCM in extreme preterm infants are still unaddressed [2]. ILCOR recommends against the routine use of cord milking for infants born at less than 29 weeks of gestation (not in all preterms, as mentioned by authors in the introduction and as a rationale for their study) outside of a research setting. In this study, the median gestation was 29 weeks; hence results cannot be applied for the extreme preterm infants, for which evidence is most needed. Moreover, delayed cord clamping (DCC) is a standard of care in preterm non-asphyxiated infants, therefore; comparison of UCM with DCC would have been more meaningful [2]. Also, a subgroup analysis of outcome among asphyxiated infants will be important.

The authors assumed very high (60%) incidence of baseline intraventricular hemorrhage (IVH) and the margin of reduction (40%). In this, as well as previous studies, the incidence of IVH in infants born at less than 32 weeks is around 20–30% only. These assumptions led to a smaller sample size selection reducing statistical power (54.7%), thus the study findings cannot be generalized.

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References

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Authors and Affiliations

  1. Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Jogender Kumar

  2. Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India

    Arushi Yadav

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  1. Jogender Kumar
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  2. Arushi Yadav
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Correspondence to Jogender Kumar.

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Kumar, J., Yadav, A. Umbilical cord milking in preterm infants: time to act. J Perinatol 39, 889–890 (2019). https://doi.org/10.1038/s41372-019-0377-y

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