Umbilical cord milking improves transition in premature infants at birth.
BACKGROUND
Umbilical cord milking (UCM) improves blood pressure and urine output, and decreases the need for transfusions in comparison to immediate cord clamping (ICC). The immediate effect of UCM in the first few minutes of life and the impact on neonatal resuscitation has not been described.


METHODS
Women admitted to a tertiary care center and delivering before 32 weeks gestation were randomized to receive UCM or ICC. A blinded analysis of physiologic data collected on the newborns in the delivery room was performed using a data acquisition system. Heart rate (HR), SpO2, mean airway pressure (MAP), and FiO2 in the delivery room were compared between infants receiving UCM and infants with ICC.


RESULTS
41 of 60 neonates who were enrolled and randomized had data from analog tracings at birth. 20 of these infants received UCM and 21 had ICC. Infants receiving UCM had higher heart rates and higher SpO2 over the first 5 minutes of life, were exposed to less FiO2 over the first 10 minutes of life than infants with ICC.


CONCLUSIONS
UCM when compared to ICC had decreased need for support immediately following delivery, and in situations where resuscitation interventions were needed immediately, UCM has the advantage of being completed in a very short time to improve stability following delivery.


BACKGROUND
ClinicalTrials.gov NCT01434732.
Division of Neonatology, UCSD Medical Center, University of California San Diego, San Diego, California, United States of America.
Anup
A
Katheria
Division of Neonatology, UCSD Medical Center, University of California San Diego, San Diego, California, United States of America.
Doug
D
Blank
Division of Neonatology, UCSD Medical Center, University of California San Diego, San Diego, California, United States of America.
Wade
W
Rich
Division of Neonatology, UCSD Medical Center, University of California San Diego, San Diego, California, United States of America.
Neil
N
Finer
D001794:Blood Pressure / Q000502:physiology*; D003250:Constriction; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D036801:Parturition / Q000502:physiology*; D011247:Pregnancy; D014470:Umbilical Cord / Q000502:physiology*