Umbilical cord clamping and preterm infants: a randomised trial.
OBJECTIVE
To investigate the clinical effects of regulating umbilical cord clamping in preterm infants.


METHODS
A prospective randomised study.


METHODS
The Queen Mother's Hospital, Glasgow.


METHODS
36 vaginally delivered infants over 27 and under 33 weeks' gestation.


METHODS
Holding the infant 20 cm below the introitus for 30 seconds before clamping the umbilical cord ("regulated" group, 17 patients), or conventional management ("random" group, 19 patients).


METHODS
Initial packed cell volume, peak serum bilirubin concentrations, red cell transfusion requirements, and respiratory impairment (assessed by ventilatory requirements, arterial-alveolar oxygen tension ratio over the first day in ventilated infants, and duration of dependence on supplemental oxygen).


RESULTS
There were statistically significant differences between the two groups in mean initial packed cell volume (regulated group 0.564, random group 0.509) and median red cell transfusion requirements (regulated group zero, random group 23 ml/kg). 13 infants from each group underwent mechanical ventilation and showed significant differences in mean minimum arterial-alveolar oxygen tension ratio on the first day (regulated group 0.42, random group 0.22) and in median duration of dependence on supplemental oxygen (regulated group three days, random group 10 days). Differences in final outcome measures such as duration of supplemental oxygen dependence and red cell transfusion requirements were mediated primarily through arterial-alveolar oxygen tension ratio and also packed cell volume.


CONCLUSIONS
This intervention at preterm deliveries produces clinical and economic benefits.
Kinmond
S
S
Queen Mother's Hospital, Department of Child Health, University of Glasgow.
Aitchison
T C
TC
Holland
B M
BM
Jones
J G
JG
Turner
T L
TL
Wardrop
C A
CA
D001663:Bilirubin / Q000097:blood; D001724:Birth Weight; D016913:Blood Component Transfusion; D003250:Constriction; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D011181:Postnatal Care; D012121:Respiration, Artificial; D013997:Time Factors; D016896:Treatment Outcome; D014470:Umbilical Cord
D001663:Bilirubin