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Randomized Controlled Trial
. 2025 Jan;45(1):85-93.
doi: 10.1038/s41372-024-02143-7. Epub 2024 Oct 11.

Association of delayed cord clamping with acute kidney injury and two-year kidney outcomes in extremely premature neonates: a secondary analysis of the preterm erythropoietin neuroprotection trial (PENUT)

Henry A Zapata #  1 , Namrata Todurkar #  2 , Kristen Favel  3 , Russell L Griffin  4 , Michelle C Starr  5 , Jennifer R Charlton  6 , Ryan M McAdams  7 , David Askenazi  8 , Tapas Kulkarni  2 , Shina Menon  9 , Cherry Mammen  2 , Matthew W Harer  10
Affiliations
Randomized Controlled Trial

Association of delayed cord clamping with acute kidney injury and two-year kidney outcomes in extremely premature neonates: a secondary analysis of the preterm erythropoietin neuroprotection trial (PENUT)

Henry A Zapata et al. J Perinatol. 2025 Jan.

Abstract

Background: Delayed cord clamping (DCC) occurs in most preterm births.

Objective: Evaluate the association of DCC with acute kidney injury (AKI) and two-year kidney outcomes.

Methods: Secondary analysis of the Preterm Erythropoietin Neuroprotection Trial of neonates born 240/7 to 276/7 weeks gestation. AKI and two year kidney outcomes were compared in neonates with DCC ( ≥ 30 s after delivery) to those with early cord clamping (ECC) (<30 s after delivery).

Results: The incidence and severity of AKI did not differ between the DCC and ECC groups (aOR 1.17 [95%CI 0.76-1.80]). At two years corrected age, DCC was associated with a 4.5-fold increased adjusted odds of estimated glomerular filtration rate (eGFR) <90 mL/min/1.73m2. No significant associations were noted between DCC and albuminuria or elevated blood pressure.

Conclusions: DCC was not associated with decreased neonatal AKI, but was associated with higher adjusted odds of eGFR <90 mL/min/1.73m2 at two years.

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Conflict of interest statement

Competing interests: The authors declare no competing interests. Consent: Consent was required for parent study but not for this secondary analysis.

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