Efficacy of umbilical cord milking compared with early clamping to prevent anemia in preterm newborns

OBJECTIVE: To know the efficacy of milking the umbilical cord compared with early clamping to prevent anemia in premature infants. MATERIAL AND METHODS: Open randomized clinical trial in two groups: early clamping or umbilical cord milking. We evaluate basal hemoglobin, requirement and number of transfusions, total blood volume transfused and frequency of adverse reactions. We used T Student to compare continuous variables, U de Mann Whitney to parametric variables and chi(2) to categorical variables, in addition we perform corrected multivariate analyses for transfusion adjusted to birth weight, comorbidities, basal hemoglobin and type of procedure. It was considered significant p < 0.05. RESULTS: We studied 91 premature patients, 46 (50.5%) in the milking group and 45 (49.5%) in the group with early clamping. Hemoglobin at 24 hours of age in the milking group was significantly higher: 17.08 +/- 2 g/dL vs 14.74 +/- 1,78 g/dL; p = 0.001. The frequency of anemia: 22 (47.8%) vs 33 (73.3%); p = 0.001, the transfusion requirement: 19(41.3%) vs 31 (68.8%); p = 0.002, and the mean volume transfused: 18.2 +/- 33.6 mL vs 35.3 +/- 45 mL; p = 0.04 were significantly lower in the milking group compared with the early clamping group. There were no differences in polycythemia presentation (p = 0.57); hyperbilirubinemia (p = 0.81) and hospital stay (p = 0.21). The level of basal hemoglobin, weight < 1000 g, gestational age < 30 weeks and early clamping was directly related to the need for transfusion. CONCLUSIONS: The milking of the umbilical cord is a useful and safe procedure for the prevention of anemia in premature newborns.