Periventricular/intraventricular hemorrhage following early and delayed umbilical cord clamping. A randomized controlled trial.
OBJECTIVE
To test the hypothesis that early compared with delayed clamping of the umbilical cords of low-birthweight babies may increase the incidence of periventricular/intraventricular hemorrhage (PVH/IVH).


METHODS
Randomized controlled trial.


METHODS
The labor wards of 3 teaching hospitals of the University of the Witwatersrand, Johannesburg.


METHODS
Women expected to give birth to babies weighing less than 2000 g.


METHODS
Allocation by randomly ordered, sealed cards to a policy either of clamping the umbilical cord immediately after delivery, or, if possible, delaying cord clamping for 1 to 2 min.


METHODS
Ultrasound diagnosis of PVH/IVH about 24 h after birth by an observer blind to the allocation of each patient.


RESULTS
PVH/IVH was diagnosed in 8/40 (20%) of neonates following delayed umbilical cord clamping and 11/46 (24%) following early cord clamping (odds ratio 0.80; 95% confidence interval, 0.29 to 2.20).


CONCLUSIONS
This study does not confirm that early clamping of the umbilical cord may contribute to the initiation of PVH/IVH in low-birthweight neonates, but further studies are required before the hypothesis can be rejected with confidence.
Hofmeyr
G J
GJ
Department of Obstetrics and Gynaecology, Coronation Hospital, Parktown, South Africa.
Gobetz
L
L
Bex
P J
PJ
Van der Griendt
M
M
Nikodem
C
C
Skapinker
R
R
Delahunt
T
T
D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000517:prevention & control; D003250:Constriction; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D010865:Pilot Projects; D011247:Pregnancy; D013997:Time Factors; D014470:Umbilical Cord