The influence of the timing of cord clamping on postnatal cerebral oxygenation in preterm neonates: a randomized, controlled trial.
OBJECTIVE
Our goal was to investigate the effect of placentofetal transfusion on cerebral oxygenation in preterm infants by near-infrared spectroscopy.


METHODS
A total of 39 preterm infants with a median gestational age of 30.4 weeks were randomly assigned to an experiment group (n = 15) and a control group (n = 24).


METHODS
The delivery of the infants in the experiment group was immediately followed by maternal administration of syntocinon, the infant was placed 15 cm below the placenta, and cord clamping was delayed by 60 to 90 seconds. The infants in the control group were delivered conventionally. At the ages of 4 and 24 hours, cerebral hemoglobin concentrations, cerebral blood volume, and regional tissue oxygenation were measured by near-infrared spectroscopy.


RESULTS
Cerebral blood volume was not different between the 2 groups at the age of 4 hours (6.1 vs 5.8 mL/100 g of tissue) nor at the age of 24 hours (6.2 vs 6.2 mL/100 g of tissue). Mean regional tissue oxygenation of the experiment group was higher at the ages of 4 hours (69.9% vs 65.5%) and of 24 hours (71.3% vs 68.1%).


CONCLUSIONS
Delayed clamping of the umbilical cord improves cerebral oxygenation in preterm infants in the first 24 hours.
Baenziger
Oskar
O
Department of Neonatology, University Hospital Zurich, Zurich, Switzerland. oskar.baenziger@kispi.unizh.ch
Stolkin
Florian
F
Keel
Mathias
M
von Siebenthal
Kurt
K
Fauchere
Jean-Claude
JC
Das Kundu
Seema
S
Dietz
Vera
V
Bucher
Hans-Ulrich
HU
Wolf
Martin
M
D001794:Blood Pressure; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003250:Constriction; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006400:Hematocrit; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D010100:Oxygen / Q000378:metabolism*; D021041:Placental Circulation / Q000502:physiology; D011247:Pregnancy; D019265:Spectroscopy, Near-Infrared; D013687:Telencephalon / Q000378:metabolism*; D013997:Time Factors; D014470:Umbilical Cord
D010100:Oxygen