title: Delayed cord clamping and inotrope use in preterm infants.
abstract: OBJECTIVE
  To evaluate the impact of delayed cord clamping (DCC) on need for inotropic support and mean arterial blood pressure (MABP).
  
  
  METHODS
  This is a single-center, prospective case-control study of premature infants, born <32 weeks gestation, who underwent DCC in comparison to a matched control group who underwent immediate cord clamping (ICC). The primary outcomes were the differences in MABP and inotropic medication used over the first week of life. Secondary outcomes included the admission hemoglobin, need for blood transfusion, and rates of intraventricular hemorrhage (IVH). Infants were matched on EGA, birth weight, sex, antenatal corticosteroid and magnesium exposure, and presence of chorioamnionitis.
  
  
  RESULTS
  Hundred and fifty-eight infants (DCC n = 79, ICC n = 79) were included. Demographic factors were similar between groups. DCC infants had a higher admission hemoglobin (p < .01), reduced incidence of high-grade IVH (p = .03), fewer median transfusions (p = .03), and were discharged at an earlier post-menstrual age (p = .04). When controlling for other factors, DCC was not associated with a reduction in inotrope use (p = .22) but was associated with a reduction in high-grade IVH (p = .01). There was no difference in MABP between the groups.
  
  
  CONCLUSIONS
  DCC is not associated with a reduction in the use of inotropes or a difference in MABP.
authors.affiliation: a Division of Newborn Medicine, Edward Mallinckrodt Department of Pediatrics , Washington University School of Medicine , St. Louis , MO , USA.
authors.forename: Zachary A
authors.identifier: http://orcid.org/0000-0001-8290-0069
authors.initials: ZA
authors.lastname: Vesoulis
authors.affiliation: b Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Washington University School of Medicine , St. Louis , MO , USA.
authors.forename: Janine
authors.initials: J
authors.lastname: Rhoades
authors.affiliation: a Division of Newborn Medicine, Edward Mallinckrodt Department of Pediatrics , Washington University School of Medicine , St. Louis , MO , USA.
authors.forename: Pournika
authors.initials: P
authors.lastname: Muniyandi
authors.affiliation: b Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Washington University School of Medicine , St. Louis , MO , USA.
authors.forename: Shayna
authors.initials: S
authors.lastname: Conner
authors.affiliation: b Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Washington University School of Medicine , St. Louis , MO , USA.
authors.forename: Alison G
authors.initials: AG
authors.lastname: Cahill
authors.affiliation: a Division of Newborn Medicine, Edward Mallinckrodt Department of Pediatrics , Washington University School of Medicine , St. Louis , MO , USA.
authors.forename: Amit M
authors.identifier: http://orcid.org/0000-0003-3529-7548
authors.initials: AM
authors.lastname: Mathur
mesh_terms: D062186:Arterial Pressure; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000517:prevention & control*; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors; D014470:Umbilical Cord
keywords: Delayed cord clamping; hypotension; inotropes; intraventricular hemorrhage; prematurity