Umbilical Cord Milking Versus Delayed Cord Clamping in Infants 28 to 32 Weeks: A Randomized Trial.
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Katheria Anup, Szychowski Jeff, Carlo Waldemar A, Subramaniam Akila, Reister Frank, Essers Jochen, Vora Farha, Martin Courtney, Schmölzer Georg M, Law Brenda, Dempsey Eugene, O'Donoghue Keelin, Kaempf Joseph, Tomlinson Mark, Fulford Kevin, Folsom Bergen, Karam Simon, Morris Rachael, Yanowitz Toby, Beck Stacy, Clark Erin, DuPont Tara, Biniwale Manoj, Ramanathan Rangasamy, Bhat Shazia, Hoffman Matthew, Chouthai Nitin, Bany-Mohammed Fayez, Mydam Janardhan, Narendran Vivek, Wertheimer Fiona, Gollin Yvonne, Vaucher Yvonne, Arnell Kathy, Varner Michael, Cutter Gary, Wilson Nicole, Rich Wade, RRT, Finer Neil
Аннотация
METHODS: Noninferiority randomized controlled trial comparing UCM versus DCC in preterm infants born 28 to 32 weeks recruited between June 2017 through September 2022 from 19 university and private medical centers in 4 countries. The primary outcome was Grade III/IV IVH or death evaluated at a 1% noninferiority margin.
RESULTS: Among 1019 infants (UCM n = 511 and DCC n = 508), all completed the trial from birth through initial hospitalization (mean gestational age 31 weeks, 44% female). For the primary outcome, 7 of 511 (1.4%) infants randomized to UCM developed severe IVH or died compared to 7 of 508 (1.4%) infants randomized to DCC (rate difference 0.01%, 95% confidence interval: (-1.4% to 1.4%), P = .99).
CONCLUSIONS: In this randomized controlled trial of UCM versus DCC among preterm infants born between 28 and 32 weeks' gestation, there was no difference in the rates of severe IVH or death. UCM may be a safe alternative to DCC in premature infants born at 28 to 32 weeks who require resuscitation.