Bikramjit Das1, Venkataseshan Sundaram2,3, Praveen Kumar1, William T Mordi4, Lakhbir K Dhaliwal5, Reena Das6. 1. Neonatal Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India. 2. Neonatal Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India. venkatpgi@gmail.com. 3. Newborn Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India. venkatpgi@gmail.com. 4. WINNER Centre for Newborn Research, NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia. 5. Neonatal Unit, Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. 6. Neonatal Unit, Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Abstract
OBJECTIVE: To assess the effect of placental transfusion by delayed cord clamping (DCC) of 60 s or cord milking (CM) on serum ferritin levels at hospital discharge and 3 mo of postmenstrual age (PMA) in preterm neonates of 30 to 33 wk gestation in comparison toearly cord clamping (ECC) within 10 s. METHODS: This mixed longitudinal study was conducted in moderately preterm neonates of 30 to 33 wk gestation born in a level III unit in Northern India with the study sample nested within a randomized controlled trial on placental transfusion. Intervention was delayed cord clamping for 60 s or cord milking compared with early cord clamping (within 10 s). Primary outcome measure was serum ferritin levels at discharge. Secondary outcome measures were serum ferritin levels at 3 mo PMA, incidence of anemia, need for blood transfusion and incidence of iron deficiency by 3 mo PMA. RESULTS: Out of the 215 randomly chosen infants, serum ferritin levels were estimated at least at one time point (at discharge or at 3 mo PMA) in 197 neonates [placental transfusion - 107; early cord clamping - 90]. Amongst them, ferritin level was estimated at discharge in 141 neonates, at 3 mo PMA in 76 neonates and at both time points in 20 neonates. Median (IQR) serum ferritin (μg/L) at discharge was significantly higher in placental transfusion group in comparison to the ECC group [399 (309,600) (n = 79) vs. 254 (190,311) (n = 62); p < 0.001]. Median (IQR) ferritin level at 3 mo PMA was not different between the study groups [20 (14,57) (n = 39) vs. 24 (8,52) (n = 37); p = 0.2]. The incidence of anemia by 3 mo PMA was significantly lesser in the placental transfusion group. No difference was observed in anemia requiring blood transfusion and iron deficiency by 3 mo PMA between the groups. CONCLUSIONS: In 30 to 33 wk preterm neonates, placental transfusion resulted in significantly higher serum ferritin at discharge in comparison to early cord clamping. However, this benefit did not persist till 3 mo PMA.
RCT Entities:
OBJECTIVE: To assess the effect of placental transfusion by delayed cord clamping (DCC) of 60 s or cord milking (CM) on serum ferritin levels at hospital discharge and 3 mo of postmenstrual age (PMA) in preterm neonates of 30 to 33 wk gestation in comparison to early cord clamping (ECC) within 10 s. METHODS: This mixed longitudinal study was conducted in moderately preterm neonates of 30 to 33 wk gestation born in a level III unit in Northern India with the study sample nested within a randomized controlled trial on placental transfusion. Intervention was delayed cord clamping for 60 s or cord milking compared with early cord clamping (within 10 s). Primary outcome measure was serum ferritin levels at discharge. Secondary outcome measures were serum ferritin levels at 3 mo PMA, incidence of anemia, need for blood transfusion and incidence of iron deficiency by 3 mo PMA. RESULTS: Out of the 215 randomly chosen infants, serum ferritin levels were estimated at least at one time point (at discharge or at 3 mo PMA) in 197 neonates [placental transfusion - 107; early cord clamping - 90]. Amongst them, ferritin level was estimated at discharge in 141 neonates, at 3 mo PMA in 76 neonates and at both time points in 20 neonates. Median (IQR) serum ferritin (μg/L) at discharge was significantly higher in placental transfusion group in comparison to the ECC group [399 (309,600) (n = 79) vs. 254 (190,311) (n = 62); p < 0.001]. Median (IQR) ferritin level at 3 mo PMA was not different between the study groups [20 (14,57) (n = 39) vs. 24 (8,52) (n = 37); p = 0.2]. The incidence of anemia by 3 mo PMA was significantly lesser in the placental transfusion group. No difference was observed in anemia requiring blood transfusion and iron deficiency by 3 mo PMA between the groups. CONCLUSIONS: In 30 to 33 wk preterm neonates, placental transfusion resulted in significantly higher serum ferritin at discharge in comparison to early cord clamping. However, this benefit did not persist till 3 mo PMA.
Entities:
Keywords:
Cord milking; Delayed cord clamping; Early cord clamping; Ferritin; Iron deficiency; Moderately preterm; Neonate; Placental transfusion
Authors: Narendra Aladangady; Siobhan McHugh; Thomas C Aitchison; Charles A J Wardrop; Barbara M Holland Journal: Pediatrics Date: 2006-01 Impact factor: 7.124
Authors: Anna Lene Seidler; Gillian M L Gyte; Heike Rabe; José L Díaz-Rossello; Lelia Duley; Khalid Aziz; Daniela Testoni Costa-Nobre; Peter G Davis; Georg M Schmölzer; Colleen Ovelman; Lisa M Askie; Roger Soll Journal: Pediatrics Date: 2021-03 Impact factor: 7.124