Umbilical Cord Milking Versus Delayed Cord Clamping in Infants 28 to 32 Weeks: A Randomized Trial

被引：18

作者：

Katheria, Anup ^{[1
,19
]}

Szychowski, Jeff ^{[2
]}

Carlo, Waldemar A. ^{[2
]}

Subramaniam, Akila ^{[2
]}

Reister, Frank ^{[3
]}

Essers, Jochen ^{[3
]}

Vora, Farha ^{[4
]}

Martin, Courtney ^{[4
]}

Schmoelzer, Georg M. ^{[5
]}

Law, Brenda ^{[5
]}

Dempsey, Eugene ^{[6
]}

O'Donoghue, Keelin ^{[6
]}

Kaempf, Joseph ^{[7
]}

Tomlinson, Mark ^{[7
]}

Fulford, Kevin ^{[8
]}

Folsom, Bergen ^{[8
]}

Karam, Simon ^{[9
]}

Morris, Rachael ^{[9
]}

Yanowitz, Toby ^{[10
]}

Beck, Stacy ^{[10
]}

Clark, Erin ^{[11
]}

Dupont, Tara ^{[11
]}

Biniwale, Manoj ^{[12
]}

Ramanathan, Rangasamy ^{[12
]}

Bhat, Shazia ^{[13
]}

Hoffman, Matthew ^{[13
]}

Chouthai, Nitin ^{[14
]}

Bany-Mohammed, Fayez ^{[15
]}

Mydam, Janardhan ^{[16
]}

Narendran, Vivek ^{[17
]}

Wertheimer, Fiona ^{[12
]}

Gollin, Yvonne ^{[1
]}

Vaucher, Yvonne ^{[18
]}

Arnell, Kathy ^{[1
]}

Varner, Michael ^{[11
]}

Cutter, Gary ^{[2
]}

Wilson, Nicole ^{[2
]}

Rich, Wade ^{[1
]}

Finer, Neil ^{[1
]}

机构：

[1] Sharp Mary Birch Hosp Women & Newborns, Neonatal Res Inst, San Diego, CA USA

[2] Univ Alabama Birmingham, Birmingham, AL USA

[3] Univ Ulm, Dept Pediat & Obstet, Ulm, Germany

[4] Loma Linda Univ, Dept Pediat & Obstet, Loma Linda, CA USA

[5] Univ Alberta, Dept Pediat, Edmonton, AB, Canada

[6] Univ Coll Cork, Dept Pediat & Obstet, Cork, Ireland

[7] Providence St Vincent Med Ctr, Women & Childrens Serv, Portland, OR USA

[8] Sharp Grossmont Hosp, Dept Pediat & Obstet, La Mesa, CA USA

[9] Univ Mississippi, Med Ctr, Dept Pediat & Obstet, Jackson, MS USA

[10] Magee Womens Hosp UPMC, Dept Pediat & Obstet, Pittsburgh, PA USA

[11] Univ Utah, Dept Pediat & Obstet, Salt Lake City, UT USA

[12] Univ Southern Calif, Keck Sch Med, Dept Pediat, Los Angeles, CA USA

[13] Christiana Care Hlth Syst, Dept Pediat & Obstet, Newark, DE USA

[14] St Louis Univ, Dept Pediat, Sch Med, St Louis, MO USA

[15] Univ Calif Irvine, Sch Med, Dept Pediat, Orange, CA USA

[16] John H Stroger Jr Hosp Cook Cty, Dept Pediat, Chicago, IL USA

[17] Cincinnati Childrens Hosp Med Ctr, Dept Pediat & Obstet, Cincinnati, OH USA

[18] Univ Calif San Diego, Dept Pediat, San Diego, CA USA

[19] Sharp Mary Birch Hosp Women & Newborns, Neonatal Res Inst, 3003 Hlth Ctr Dr, San Diego, CA 92123 USA

来源：

PEDIATRICS | 2023年 / 152卷 / 06期

关键词：

CARDIOVASCULAR CARE SCIENCE; CARDIOPULMONARY-RESUSCITATION; INTERNATIONAL CONSENSUS; HEMORRHAGE; PREVENTION; MANAGEMENT; VOLUME;

D O I：

10.1542/peds.2023-063113

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

OBJECTIVES: To determine whether rate of severe intraventricular hemorrhage (IVH) or death among preterm infants receiving placental transfusion with UCM is noninferior to delayed cord clamping (DCC). METHODS: Noninferiority randomized controlled trial comparing UCM versus DCC in preterm infants born 28 to 32 weeks recruited between June 2017 through September 2022 from 19 university and private medical centers in 4 countries. The primary outcome was Grade III/IV IVH or death evaluated at a 1% noninferiority margin. RESULTS: Among 1019 infants (UCM n = 511 and DCC n = 508), all completed the trial from birth through initial hospitalization (mean gestational age 31 weeks, 44% female). For the primary outcome, 7 of 511 (1.4%) infants randomized to UCM developed severe IVH or died compared to 7 of 508 (1.4%) infants randomized to DCC (rate difference 0.01%, 95% confidence interval: (-1.4% to 1.4%), P = .99). CONCLUSIONS: In this randomized controlled trial of UCM versus DCC among preterm infants born between 28 and 32 weeks' gestation, there was no difference in the rates of severe IVH or death. UCM may be a safe alternative to DCC in premature infants born at 28 to 32 weeks who require resuscitation.

引用

页数：8

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