Placental transfusion: umbilical cord clamping and preterm infants.
OBJECTIVE
To investigate the clinical effects of early versus late cord clamping in preterm infants.


METHODS
A total of 32 premature infants were prospectively randomized. The following parameters were measured: Initial spun hematocrit (Hct), hemoglobin (Hgb), red blood cell (RBC) counts, frequency of blood transfusions, peak serum bilirubin, mean blood pressure (MBP), oxygen index, intraventricular hemorrhage, and significant patent ductus arteriosus (PDA).


RESULTS
Over the 4-week study period, the delayed cord clamping (DCC) group exhibited a decrease in the frequency of blood transfusion (p < 0.001) and also a decrease in albumin transfusions over the first 24 hours (p < 0.03). MBP in the first 4 hours was higher in the DCC group (p < 0.01), and there were statistically significant increases in Hct (21%), Hgb (23%), and RBC count (21%) compared with the early cord clamping group. The risks of patent ductus arteriosus, hyperbilirubinemia, or intraventricular hemorrhage were similar in both groups. Late clamping of the umbilical cord had little or no effect on the oxygen index.


CONCLUSIONS
DCC significantly reduced the requirement for blood and albumin transfusion. It also increased the initial Hct, RBC count, Hgb levels, and MBP.
Ibrahim
H M
HM
Division of Neonatology, Louisiana State University Medical Center, Sbreveport 71130-3932, USA.
Krouskop
R W
RW
Lewis
D F
DF
Dhanireddy
R
R
D016913:Blood Component Transfusion; D001794:Blood Pressure; D001803:Blood Transfusion; D003250:Constriction; D004906:Erythrocyte Count; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D010920:Placenta / Q000098:blood supply*; D011247:Pregnancy; D011446:Prospective Studies; D012709:Serum Albumin; D013997:Time Factors; D014470:Umbilical Cord
D006454:Hemoglobins; D012709:Serum Albumin