Effect of delayed cord clamping on the risk of bronchopulmonary dysplasia in preterm infants with respiratory distress.

PURPOSE: To assess the incidence of bronchopulmonary dysplasia in preterm infants born at < 32 weeks of gestation who received delayed cord clamping rather than early cord clamping.

METHODS

During this multicenter, prospective, observational cohort study, data of 1283 infants born at < 32 weeks of gestation who received umbilical cord management between January 1, 2020 and December 31, 2021, were collected from 26 tertiary referral neonatal intensive care units in China. The primary outcome was bronchopulmonary dysplasia.

RESULTS

A total of 440 infants (34.3%) received delayed cord clamping. The bronchopulmonary dysplasia rates were 32.5% and 55.6% for infants who received delayed cord clamping and those who received early cord clamping, respectively. After adjusting for potential confounders, the delayed cord clamping group had a lower risk of bronchopulmonary dysplasia (odds ratio [OR], 0.47; 95% confidence interval [CI], 0.35-0.62; P < 0.001). No significant difference in the severity of bronchopulmonary dysplasia was observed between groups (P = 0.09). A subgroup analysis of 227 infants born at < 28 weeks of gestation revealed that 65 (28.6%) received delayed cord clamping, and that 40 (61.5%) of these 65 infants experienced bronchopulmonary dysplasia. After adjusting for potential confounders, the risk of bronchopulmonary dysplasia for the delayed cord clamping group was not decreased (OR, 0.65; 95% CI, 0.30-1.41; P = 0.28).

CONCLUSION

Delayed cord clamping independently decreased the risk of bronchopulmonary dysplasia in infants born at < 32 weeks of gestation with moderate-to-severe respiratory distress; however, for those born at < 28 weeks of gestation, this benefit was not observed.