title: Effects of delayed cord clamping in very-low-birth-weight infants.
abstract: OBJECTIVE
  Delayed cord clamping (DCC) may be beneficial in very-preterm and very-low-birth-weight infants.
  
  
  METHODS
  This study was a randomized unmasked controlled trial. It was performed at three centers of the NICHD (National Institute of Child Health and Human Development) Neonatal Research Network. DCC in very-preterm and very-low-birth-weight infants will result in an increase in hematocrit levels at 4 h of age. Infants with a gestational age of 24 to 28 weeks were randomized to either early cord clamping (<10 s) or DCC (30 to 45 s). The primary outcome was venous hematocrit at 4 h of age. Secondary outcomes included delivery room management, selected neonatal morbidities and the need for blood transfusion during the infants' hospital stay.
  
  
  RESULTS
  A total of 33 infants were randomized: 17 to the immediate cord clamping group (cord clamped at 7.9±5.2 s, mean±s.d.) and 16 to the DCC (cord clamped at 35.2±10.1 s) group. Hematocrit was higher in the DCC group (45±8% vs 40±5%, P<0.05). The frequency of events during delivery room resuscitation was almost identical between the two groups. There was no difference in the hourly mean arterial blood pressure during the first 12 h of life; there was a trend in the difference in the incidence of selected neonatal morbidities, hematocrit at 2, 4 and 6 weeks, as well as the need for transfusion, but none of the differences was statistically significant.
  
  
  CONCLUSIONS
  A higher hematocrit is achieved by DCC in very-low-birth-weight infants, suggesting effective placental transfusion.
authors: Department of Pediatrics, Women and Infants' Hospital, 101 Dudley Street, Providence, RI 02905, USA. woh@wihri.org
authors: W
authors: W
authors: Oh
authors: A A
authors: AA
authors: Fanaroff
authors: W A
authors: WA
authors: Carlo
authors: E F
authors: EF
authors: Donovan
authors: S A
authors: SA
authors: McDonald
authors: W K
authors: WK
authors: Poole
mesh_terms: D003250:Constriction; D036861:Delivery, Obstetric / Q000379:methods*; D006400:Hematocrit; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D014470:Umbilical Cord