Umbilical cord milking reduces the risk of intraventricular hemorrhage in preterm infants born before 32 weeks of gestation

J Perinatol. 2019 Apr;39(4):547-553. doi: 10.1038/s41372-019-0329-6. Epub 2019 Feb 5.

Abstract

Objective: Intraventricular hemorrhage (IVH) is a common complication in extremely preterm infants. We aimed to demonstrate that umbilical cord milking (UCM) would reduce the incidence of IVH in this at risk population.

Study design: We compared the incidence of IVH in a prospective cohort of consecutively born preterm infants <32 weeks' gestation receiving UCM (n = 33) with a historical cohort that underwent immediate cord clamping (ICC) (n = 36).

Results: No significant differences regarding perinatal characteristics were present between both groups except for chorioamnionitis and preterm rupture of membranes which were more frequent in the UCM group. There was a significant reduction in the incidence of IVH in the UCM group as compared to the ICC group (UCM vs. ICC = 12 vs. 33%, p = 0.037; OR = 0.276 (95% CI 0.079-0.967; p = 0.033; NNT = 4.7) and a reduction in the number of transfusions (UCM vs. ICC = 56 vs. 30%, p = 0.035; OR = 0.348 (0.129-0.938; p = 0.033; NNT = 3.8). UCM was safe for mothers (similar decrease in maternal hemoglobin) and offspring.

Conclusion: UCM significantly reduced the incidence of IVH in preterm infants < 32 weeks' gestation without associated complications for mother or offspring.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Transfusion
  • Cerebral Intraventricular Hemorrhage / prevention & control*
  • Cerebrovascular Circulation
  • Cohort Studies
  • Constriction
  • Female
  • Gestational Age
  • Humans
  • Incidence
  • Infant, Newborn
  • Infant, Premature*
  • Intensive Care Units, Neonatal
  • Male
  • Placental Circulation
  • Pregnancy
  • Prospective Studies
  • Risk
  • Umbilical Cord*