• J Formos Med Assoc · May 2022

    Randomized Controlled Trial

    A 20-cm cut umbilical cord milking may not benefit the preterm infants < 30 week's gestation: A randomized clinical trial.

    • Shang-Po Shen, Chih-Hao Chen, Hung-Yang Chang, Chyong-Hsin Hsu, Chia-Ying Lin, Wai-Tim Jim, and Jui-Hsing Chang.
    • Department of Pediatrics, Taitung MacKay Memorial Hospital, Taitung County, Taiwan; Division of Neonatology, Department of Pediatrics, MacKay Children's Hospital, Taipei City, Taiwan.
    • J Formos Med Assoc. 2022 May 1; 121 (5): 912-919.

    Background/PurposeTo evaluate whether a shorter length (20 cm) of C-UCM has potential benefits, compared to immediate cord clamping (ICC), in very preterm babies.MethodsInborn preterm infants less than 30 weeks of gestational age (GA) were randomly assigned to the 20-cm C-UMC and ICC groups. The primary outcome was the need for packed red blood cell (pRBC) transfusion before the 21st day of life. The secondary outcomes were short- and long-term outcomes related to premature birth.ResultsSeventy-six neonates were randomized to the two groups. GA were 27.2 ± 1.8 and 27.5 ± 1.7 weeks (p = 0.389) and birth weights were 987 ± 269 and 1023 ± 313 g (p = 0.601) in the 20-cm C-UCM and ICC groups, respectively. There was no significant difference between the groups in terms of the need for pRBC transfusion before the 21st day of life (59.4% versus 71.8%, adjusted odds ratio [aOR] 0.311, 95% confidence interval [CI] 0.090-1.079). An increased prevalence of late-onset sepsis was observed in the 20-cm C-UCM group compared to the ICC group (21.6% versus 5.1%, aOR 5.434, 95% CI 1.033-23.580). The mortality rates were 13.5% and 2.6% in the 20-cm C-UCM and ICC groups, respectively (aOR 5.339, 95% CI 0.563-50.626). The neurodevelopmental outcomes at 2 years of corrected age between the groups were also not statistically significant.ConclusionA 20-cm C-UCM showed no effect on reducing the incidence of pRBC transfusion in preterm babies with GA less than 30 weeks compared with ICC in this small-scale randomized controlled trial.Copyright © 2021. Published by Elsevier B.V.

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