- Title
- Delayed versus immediate cord clamping in preterm infants
- Creator
- Tarnow-Mordi, William; Morris, Jonathan; Kirby, Adrienne; Robledo, Kristy; Askie, Lisa; Brown, Rebecca; Evans, Nicholas; Finlayson, Sarah; Fogarty, Michael; Gebski, Val; Ghadge, Alpana; Hague, Wendy; Isaacs, David; Jeffery, Michelle; Keech, Anthony; Kluckow, Martin; Popat, Himanshu; Sebastian, Lucille; Aagaard, Kjersti; Belfort, Michael; Pammi, Mohan; Abdel-Latif, Mohamed; De Waal, Koert; Forder, Peta
- Relation
- New England Journal of Medicine Vol. 377, Issue 25, p. 2445-2455
- Publisher Link
- http://dx.doi.org/10.1056/NEJMoa1711281
- Publisher
- Massachusetts Medical Society
- Resource Type
- journal article
- Date
- 2017
- Description
- Background: The preferred timing of umbilical-cord clamping in preterm infants is unclear. Methods: We randomly assigned fetuses from women who were expected to deliver before 30 weeks of gestation to either immediate clamping of the umbilical cord (=10 seconds after delivery) or delayed clamping (=60 seconds after delivery). The primary composite outcome was death or major morbidity (defined as severe brain injury on postnatal ultrasonography, severe retinopathy of prematurity, necrotizing enterocolitis, or late-onset sepsis) by 36 weeks of postmenstrual age. Analyses were performed on an intention-to-treat basis, accounting for multiple births. Results: Of 1634 fetuses that underwent randomization, 1566 were born alive before 30 weeks of gestation; of these, 782 were assigned to immediate cord clamping and 784 to delayed cord clamping. The median time between delivery and cord clamping was 5 seconds and 60 seconds in the respective groups. Complete data on the primary outcome were available for 1497 infants (95.6%). There was no significant difference in the incidence of the primary outcome between infants assigned to delayed clamping (37.0%) and those assigned to immediate clamping (37.2%) (relative risk, 1.00; 95% confidence interval, 0.88 to 1.13; P=0.96). The mortality was 6.4% in the delayed-clamping group and 9.0% in the immediate-clamping group (P=0.03 in unadjusted analyses; P=0.39 after post hoc adjustment for multiple secondary outcomes). There were no significant differences between the two groups in the incidences of chronic lung disease or other major morbidities. Conclusions: Among preterm infants, delayed cord clamping did not result in a lower incidence of the combined outcome of death or major morbidity at 36 weeks of gestation than immediate cord clamping.
- Subject
- umbilical-cord; preterm infants; cord clamping; morbidity rates
- Identifier
- http://hdl.handle.net/1959.13/1394056
- Identifier
- uon:33645
- Identifier
- ISSN:0028-4793
- Rights
- © 2017 Massachusetts Medical Society.
- Language
- eng
- Full Text
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