title: [Delayed umbilical cord clamping in preterm infants born before 37 weeks of gestation: A prospective observational study].
abstract: OBJECTIVE
  Many international studies have demonstrated that delayed umbilical cord clamping reduces neonatal morbidity. However, in France, delayed umbilical cord clamping is still not performed in many neonatal units. The aims of this study were to evaluate the feasibility of developing a protocol of delayed umbilical cord clamping in the maternity ward of the Toulouse university hospital and to evaluate the impact of this new protocol on neonatal mortality.
  
  
  METHODS
  We conducted a prospective observational study including 123 preterm infants born before 37 weeks of gestation between June 2012 and June 2013 and hospitalized at birth. Delayed cord clamping was performed for at least 30s after birth; otherwise, it was evaluated as early cord clamping. We excluded twin-to-twin transfusion syndrome, congenital abnormalities, alloimmunization, and perinatal asphyxia. We analyzed the reasons why delayed umbilical cord clamping was not performed and then neonatal morbidity in our population.
  
  
  RESULTS
  Delayed umbilical cord clamping was performed on 79 infants and 44 infants had early umbilical cord clamping. The two groups had similar baseline characteristics. Preterm infants in the delayed cord-clamping group had a higher level of hemoglobin during the first 24h of life (17.9g/dL versus 16.6g/dL, P=0.005), fewer of them required transfusion (14% versus 35%, P=0.03), and fewer presented late-onset sepsis (8% versus 26%, P=0.02) or bronchopulmonary dysplasia (9% versus 26%, P=0.03). There was no statistically significant increase of hyperbilirubinemia requiring phototherapy.
  
  
  CONCLUSIONS
  Implanting a new protocol of delayed umbilical cord clamping in our maternity ward proved to be possible without difficulty. The advantages of delayed umbilical cord clamping were observed in this prospective study. Today, delayed cord clamping has become a common practice in our maternity unit.
authors.affiliation: Service de néonatologie, hôpital des enfants, CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse, France; Inserm UMR 1027, université Paul Sabatier, 37, allées Jules-Guesde, 31062 Toulouse, France. Electronic address: odile.dicky@gmail.com.
authors.forename: O
authors.initials: O
authors.lastname: Dicky
authors.affiliation: Inserm UMR 1027, université Paul Sabatier, 37, allées Jules-Guesde, 31062 Toulouse, France.
authors.forename: V
authors.initials: V
authors.lastname: Ehlinger
authors.affiliation: Service de gynécologie-obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse, France.
authors.forename: B
authors.initials: B
authors.lastname: Guyard-Boileau
authors.affiliation: Service de néonatologie, hôpital des enfants, CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse, France.
authors.forename: C
authors.initials: C
authors.lastname: Assouline
authors.affiliation: Inserm UMR 1027, université Paul Sabatier, 37, allées Jules-Guesde, 31062 Toulouse, France.
authors.forename: C
authors.initials: C
authors.lastname: Arnaud
authors.affiliation: Service de néonatologie, hôpital des enfants, CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse, France.
authors.forename: C
authors.initials: C
authors.lastname: Casper
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000401:mortality / Q000517:prevention & control; D005240:Feasibility Studies; D005260:Female; D005602:France; D005865:Gestational Age; D006452:Hemoglobinometry; D017052:Hospital Mortality; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000517:prevention & control; D008297:Male; D011446:Prospective Studies; D055502:Secondary Prevention; D018805:Sepsis / Q000401:mortality / Q000517:prevention & control; D013525:Surgical Instruments; D014470:Umbilical Cord / Q000601:surgery*