Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May;31(10):1327-1334.
doi: 10.1080/14767058.2017.1315663. Epub 2017 Apr 20.

Delayed cord clamping and inotrope use in preterm infants

Zachary A Vesoulis  1 , Janine Rhoades  2 , Pournika Muniyandi  1 , Shayna Conner  2 , Alison G Cahill  2 , Amit M Mathur  1
Affiliations

Delayed cord clamping and inotrope use in preterm infants

Zachary A Vesoulis et al. J Matern Fetal Neonatal Med. 2018 May.

Abstract

Objective: To evaluate the impact of delayed cord clamping (DCC) on need for inotropic support and mean arterial blood pressure (MABP).

Methods: This is a single-center, prospective case-control study of premature infants, born <32 weeks gestation, who underwent DCC in comparison to a matched control group who underwent immediate cord clamping (ICC). The primary outcomes were the differences in MABP and inotropic medication used over the first week of life. Secondary outcomes included the admission hemoglobin, need for blood transfusion, and rates of intraventricular hemorrhage (IVH). Infants were matched on EGA, birth weight, sex, antenatal corticosteroid and magnesium exposure, and presence of chorioamnionitis.

Results: Hundred and fifty-eight infants (DCC n = 79, ICC n = 79) were included. Demographic factors were similar between groups. DCC infants had a higher admission hemoglobin (p < .01), reduced incidence of high-grade IVH (p = .03), fewer median transfusions (p = .03), and were discharged at an earlier post-menstrual age (p = .04). When controlling for other factors, DCC was not associated with a reduction in inotrope use (p = .22) but was associated with a reduction in high-grade IVH (p = .01). There was no difference in MABP between the groups.

Conclusions: DCC is not associated with a reduction in the use of inotropes or a difference in MABP.

Keywords: Delayed cord clamping; hypotension; inotropes; intraventricular hemorrhage; prematurity.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest and financial disclosure statement: The authors have no financial relationships relevant to this article to disclose. The authors have no conflicts of interest relevant to this article to disclose.

Figures

Figure 1
Figure 1
Longitudinal mean arterial blood pressure values over the first 7 days of life. Each point represents the average of 3 hours of data. ICC group is shown with open circular markers while the DCC group has filled diamond markers. Whiskers represent ± 1 SEM.
See this image and copyright information in PMC

References

    1. Rabe H, Diaz-Rossello JL, Duley L, et al. Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Cochrane Database Syst Rev. 2012:CD003248. - PubMed
    1. Weeks A. Umbilical cord clamping after birth. BMJ. 2007;335:312–313. - PMC - PubMed
    1. Rabe H, Wacker A, Hülskamp G, et al. A randomised controlled trial of delayed cord clamping in very low birth weight preterm infants. Eur J Pediatr. 2000;159:775–777. - PubMed
    1. Strauss RG, Mock DM, Johnson KJ, et al. A randomized clinical trial comparing immediate versus delayed clamping of the umbilical cord in preterm infants: short-term clinical and laboratory endpoints. Transfusion (Paris) 2008;48:658–665. - PMC - PubMed
    1. Hosono S, Mugishima H, Fujita H, et al. Umbilical cord milking reduces the need for red cell transfusions and improves neonatal adaptation in infants born at less than 29 weeks’ gestation: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed. 2008;93:F14–19. - PubMed