Umbilical cord milking and hematological parameters in moderate to late preterm neonates: A randomized controlled trial

Kumar, B B Santosh; Upadhyay, Amit; Gothwal, Sunil; Jaiswal, Vijay; Joshi, Payas; Dubey, Kirti

doi:10.1007/s13312-015-0711-1

Cited by 38 publications

(38 citation statements)

References 11 publications

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“…Many have included the preterm cohort. 3,7,10 The conventional testing at 6 weeks has been taken based on physiology of hemoglobin changes in preterm population which would have a physiological nadir around 4-8weeks of life and if authors could improve the iron stores around this crucial period it could translate to improved haemoglobin, which would also have an impact on neurodevelopment. [11][12][13] The method of cord milking used in our study was similar to that used in Kumar et al study.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13] The method of cord milking used in our study was similar to that used in Kumar et al study. 7 However the methods of cord milking varied across studies, while Hosono et al and Katheria et al milked 2-3times at a speed of 20cm/ 2sec. [15][16][17][18][19] All the studies have milked the cord before clamping except Upadhay et al, Kumar et al, Prateek et al that milked the cord 3 times after clamping.…”

Section: Discussionmentioning

confidence: 99%

“…[15][16][17][18][19] All the studies have milked the cord before clamping except Upadhay et al, Kumar et al, Prateek et al that milked the cord 3 times after clamping. 7,20,21 Authors chose the technique used by Kumar et al where the cord is clamped at a distance of 25 cm and only that segment of the cord is milked three times.…”

Section: Discussionmentioning

confidence: 99%

“…24 Upadhyay et al and Kumar et al have reported ferritin at 6weeks in preterm population (not requiring resuscitation) with cord milking. 7,20 Authors have not taken in to consideration the maternal iron status as previous studies have clearly demonstrated that foetal iron stores are independent of maternal status and iron is accreted by foetus at a concentration gradient. 24 The speculative possibility of increased heat loss can be expected in preterm neonates if authors practice delayed cord clamping.…”

Section: Discussionmentioning

confidence: 99%

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A randomised control trial comparing the efficacy of cord milking over the delayed cord clamping on serum ferritin level in preterm neonates at 6 weeks of age

Devadas

Roshni

Mallesh

2020

Int J Contemp Pediatr

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Background: Perinatal iron deficiency has received little attention in the past. Umbilical cord milking is a type of placental transfusion, they serve to potentially enhance neonatal blood volume and consequently the iron stores after birth. Among the neonates, the preterm infants are sick and vulnerable babies who are already deprived of iron stores. The aim of this study was to evaluate the effect of cord milking on ferritin values amongst preterm neonates.Methods: This is a hospital based randomized control trial which included the babies born at 29-36 weeks of gestation. The babies were randomized to two intervention groups; cord milking and delayed cord clamping group. Detailed clinical history taken, including details of labour and clinical examination. Blood samples were analysed for ferritin as required at 6 weeks of post-natal age.Results: Neonates under cord milking group had higher ferritin values (249.04±21.93 ng/mL) as compared to those neonates under delayed cord clamping group (179.66±32.94 ng/mL) and this was statistically very significant (p= <0.001).Conclusions: In preterm neonates, umbilical cord milking results in improved iron status as shown by higher ferritin values at 6 weeks of life. UCM can be a used as placental transfusion strategy in preterm neonates for improving iron status and preventing anemia of prematurity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A randomised control trial comparing the efficacy of cord milking over the delayed cord clamping on serum ferritin level in preterm neonates at 6 weeks of age

Devadas

Roshni

Mallesh

2020

Int J Contemp Pediatr

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“…However, in a population of term infants, early cord clamping with cord milking has shown to increase hemoglobin concentration and iron stores at 6 months of age [57]. The same procedure in late preterm infants is associated with improved iron stores at 6 weeks but also increases the risk of jaundice needing phototherapy [58].…”

Section: Cord Clampingmentioning

confidence: 99%

Respiratory Distress Syndrome Management in Delivery Room

Lista¹,

Schmölzer²,

Bresesti³

2018

Pregnancy and Birth Outcomes

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The proper management of respiratory distress syndrome in the delivery room is a crucial step in the transition to extrauterine life, especially for preterm infants. In fact, it has been widely established that the optimization of the cardiovascular and the respiratory changes, which normally happen as soon as a term healthy baby is delivered, can have long-term effects. For this reason, every clinician approaching the delivery room should be aware of the consequences an inappropriate management could lead to and should know how to perform a proper resuscitation, using, where available, the most recent techniques. Regardless of the level of care provided by the hospital, there are some key interventions, which can be applied easily in every setting and are of crucial importance. In this chapter, we aim to provide a comprehensive overview of the most relevant measures to manage respiratory distress syndrome from the delivery room, starting from an explanation of the disease and moving toward the most recent evidence, from the basic concepts to the most advanced techniques to monitor fetal-neonatal transition.

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Association of Umbilical Cord Management Strategies With Outcomes of Preterm Infants

Jasani

Torgalkar

et al. 2021

JAMA Pediatr

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IMPORTANCEIt is unclear which umbilical cord management strategy is the best for preventing mortality and morbidities in preterm infants.OBJECTIVE To systematically review and conduct a network meta-analysis comparing 4 umbilical cord management strategies for preterm infants: immediate umbilical cord clamping (ICC), delayed umbilical cord clamping (DCC), umbilical cord milking (UCM), and UCM and DCC.DATA SOURCES PubMed, Embase, CINAHL, and Cochrane CENTRAL databases were searched from inception until September 11, 2020.STUDY SELECTION Randomized clinical trials comparing different umbilical cord management strategies for preterm infants were included.DATA EXTRACTION AND SYNTHESIS Data were extracted for bayesian random-effects meta-analysis to estimate the relative treatment effects (odds ratios [OR] and 95% credible intervals [CrI]) and surface under the cumulative ranking curve values. MAIN OUTCOMES AND MEASURESThe primary outcome was predischarge mortality. The secondary outcomes were intraventricular hemorrhage, severe intraventricular hemorrhage, need for packed red blood cell transfusion, and other neonatal morbidities. Confidence in network meta-analysis software was used to assess the quality of evidence and grade outcomes.RESULTS Fifty-six studies enrolled 6852 preterm infants. Compared with ICC, DCC was associated with lower odds of mortality (22 trials, 3083 participants; 7.6% vs 5.0%; OR, 0.64; 95% CrI, 0.39-0.99), intraventricular hemorrhage (25 trials, 3316 participants; 17.8% vs 15.4%; OR, 0.73; 95% CrI, 0.54-0.97), and need for packed red blood cell transfusion (18 trials, 2904 participants; 46.9% vs 38.3%; OR, 0.48; 95% CrI, 0.32-0.66). Compared with ICC, UCM was associated with lower odds of intraventricular hemorrhage (10 trials, 645 participants; 22.5% vs 16.2%; OR, 0.58; 95% CrI, 0.38-0.84) and need for packed red blood cell transfusion (9 trials, 688 participants; 47.3% vs 32.3%; OR, 0.36; 95% CrI, 0.23-0.53), with no significant differences for other secondary outcomes. There was no significant difference between UCM and DCC for any outcome. CONCLUSIONS AND RELEVANCECompared with ICC, DCC was associated with the lower odds of mortality in preterm infants. Compared with ICC, DCC and UCM were associated with reductions in intraventricular hemorrhage and need for packed red cell transfusion. There was no significant difference between UCM and DCC for any outcome. Further studies directly comparing DCC and UCM are needed.

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Umbilical cord milking and hematological parameters in moderate to late preterm neonates: A randomized controlled trial

Abstract: In preterm neonates, umbilical cord milking at birth enhances iron stores at 6 weeks of age. Higher phototherapy rates with this intervention are a matter of concern.

Cited by 38 publications

References 11 publications

A randomised control trial comparing the efficacy of cord milking over the delayed cord clamping on serum ferritin level in preterm neonates at 6 weeks of age

A randomised control trial comparing the efficacy of cord milking over the delayed cord clamping on serum ferritin level in preterm neonates at 6 weeks of age

Respiratory Distress Syndrome Management in Delivery Room

Association of Umbilical Cord Management Strategies With Outcomes of Preterm Infants

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