Neurodevelopmental outcomes of very preterm infants who received cord milking at birth: a randomized controlled trial

Walid El-Naggar; Douglas McMillan; Arif Hussain; Anthony Armson; Linda Dodds; Andrew Warren; Robin Whyte; Michael Vincer; C David Simpson

doi:10.1007/s00431-022-04638-x

Neurodevelopmental outcomes of very preterm infants who received cord milking at birth: a randomized controlled trial

Eur J Pediatr. 2022 Dec;181(12):4215-4220. doi: 10.1007/s00431-022-04638-x. Epub 2022 Oct 4.

Authors

Walid El-Naggar¹, Douglas McMillan², Arif Hussain³, Anthony Armson⁴, Linda Dodds⁵, Andrew Warren³, Robin Whyte², Michael Vincer^{2

4}, C David Simpson²

Affiliations

¹ Division of Neonatal-Perinatal Medicine, Department of Pediatrics, IWK Health Centre, Dalhousie University, 5850/5980 University Ave., PO Box 9700, Halifax, NS, B3K 6R8, Canada. walid.el-naggar@iwk.nshealth.ca.
² Division of Neonatal-Perinatal Medicine, Department of Pediatrics, IWK Health Centre, Dalhousie University, 5850/5980 University Ave., PO Box 9700, Halifax, NS, B3K 6R8, Canada.
³ Division of Cardiology, Department of Pediatrics, Dalhousie University, Halifax, Canada.
⁴ Department of Obstetrics & Gynecology, Dalhousie University, Halifax, Canada.
⁵ Perinatal Epidemiology Research Unit, Departments of Obstetrics & Gynecology and Pediatrics, Dalhousie University, Halifax, Canada.

PMID: 36194256
DOI: 10.1007/s00431-022-04638-x

Abstract

Umbilical cord milking improves postnatal adaptation and short-term outcomes of very preterm infants compared to early cord clamping. Little is known about the impact of umbilical cord milking on long-term neurodevelopmental outcomes. The objective of this study is to compare the effects of intact umbilical cord milking (UCM) vs. early cord clamping (ECC) at birth on neurodevelopmental outcomes at 36 months' corrected age. Preterm infants < 31 weeks' gestation who were randomized at birth to receive three time milking of their attached cord or ECC (< 10 s) were evaluated at 36 months' corrected age. Neurodevelopmental outcomes were assessed by blinded examiners using Bayley Scales of Infant and Toddler Development (version III). Analysis was by intention to treat. Out of the 73 infants included in the original trial, 2 died and 65 (92%) infants were evaluated at 36 months' corrected age. Patient characteristics and short-term outcomes were similar in both study groups. There were no significant differences in the median cognitive, motor or language scores or in the rates of cerebral palsy, developmental impairment, deafness, or blindness between study groups.

Conclusion: Neurodevelopmental outcomes at 36 months' corrected age of very preterm infants who received UCM were not shown to be significantly different from those who received ECC at birth.

Trial registration: ClinicalTrials.gov: NCT01487187 What is Known: • Compared to early cord clamping, umbilical cord milking improves postnatal adaptation and short-term outcomes of very preterm infants compared to early cord clamping. • Little is known about the impact of umbilical cord milking on neurodevelopmental outcomes.

What is new: • Neurodevelopmental outcomes at 3 years of age were not significantly different in very preterm infants who received cord milking vs. those who received early cord clamping at birth.

Keywords: Early cord clamping; Long-term neurodevelopmental outcomes; Preterm infants; Umbilical cord milking.

Publication types

Randomized Controlled Trial

MeSH terms

Constriction
Female
Fetal Growth Retardation
Humans
Infant
Infant, Newborn
Infant, Premature*
Infant, Premature, Diseases*
Infant, Very Low Birth Weight
Umbilical Cord

Associated data

ClinicalTrials.gov/NCT01487187

Abstract

Publication types

MeSH terms

Associated data

Grants and funding