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The effect of umbilical cord milking on cerebral blood flow in very preterm infants: a randomized controlled study

Journal of Perinatology volume 41, pages 263–268 (2021)Cite this article

Subjects

Abstract

Objective

To compare the effect of umbilical cord milking (UCM) vs. early cord clamping (ECC) on cerebral blood flow (CBF).

Method

Preterm infants <31 weeks’ gestation were randomized to receive UCM or ECC at birth. Blood flow velocities and resistive & pulsatility indices of middle and anterior cerebral arteries were measured at 4–6 and 10–12 h after birth as an estimate of CBF.

Results

Randomization allocated 37 infants to UCM and 36 to ECC. Maternal and antenatal variables were similar. There were no significant differences between groups in middle or anterior CBF velocities and resistive indices at either study time point. CBF variables were not correlated with mean blood pressure, systemic blood flow, or intraventricular hemorrhage.

Conclusions

In very preterm infants, UCM compared with ECC was not shown to change CBF indices during the first 12 h of age or correlate with other hemodynamic measures or with intraventricular hemorrhage.

Trial registration

ClinicalTrials.gov: NCT01487187.

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Funding

This project was supported by grants from both Nova Scotia Health Research Foundation (PSO-EST-2013-9023 EGMS 1813) and IWK Research Foundation (1008052). No honorarium or other form of payment was given to anyone to produce this manuscript.

Author contributions

WE-N was involved in study design, Research Ethics Board (REB) approval, performing echocardiography studies, data review and manuscript preparation. DS was involved in conducting echocardiography studies, data review and manuscript reviewing. AH was involved in reading and interpreting echocardiography studies, data review and manuscript reviewing. AA was involved in study design, REB approval and manuscript reviewing. AW was involved in study design, REB approval and manuscript reviewing. RW was involved in study design, REB approval and manuscript reviewing. DM was involved in study design, REB approval, and manuscript reviewing. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Authors and Affiliations

  1. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Dalhousie University, Halifax, Canada

    Walid El-Naggar, Douglas McMillan, Robin Whyte & David Simpson

  2. Division of Cardiology, Department of Pediatrics, Dalhousie University, Halifax, Canada

    Arif Hussain & Andrew Warren

  3. Department of Obstetrics & Gynecology, Dalhousie University, Halifax, Canada

    Anthony Armson

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  1. Walid El-Naggar
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Correspondence to Walid El-Naggar.

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El-Naggar, W., McMillan, D., Hussain, A. et al. The effect of umbilical cord milking on cerebral blood flow in very preterm infants: a randomized controlled study. J Perinatol 41, 263–268 (2021). https://doi.org/10.1038/s41372-020-00780-2

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