Anup Katheria1, Judith Mercer2,3, Melissa Brown4, Wade Rich4, Katie Baker4, M J Harbert4, Brianna Pierce4, Kasim Hassen4, Neil Finer4. 1. Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA, USA. anup.katheria@sharp.com. 2. University of Rhode Island, Kingston, RI, USA. 3. Women and Infants Hospital and Alpert School of Medicine, Brown University, Providence, RI, USA. 4. Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA, USA.
Abstract
OBJECTIVE: To determine if umbilical cord milking is detrimental in compromised term/near-term infants. STUDY DESIGN: A retrospective analysis of infants with abnormal cord gases (cord arterial or venous pH of ≤ 7.1 or base deficit > -12). We collected maternal risk factors, cord management, birth, and neonatal outcomes during hospitalization. RESULT: We found 157 infants who met the criteria for abnormal cord gases. Thirty-six of those had umbilical cord milking at delivery. There was no significant difference in neonatal outcomes, but fewer infants in the cord milking group needed resuscitation (38 vs. 56%, p = 0.07) and ongoing respiratory support (19 vs. 31%, p = 0.16) compared to the immediate clamping group. CONCLUSIONS: While not significant, infants who received cord milking at birth needed less resuscitation and ongoing respiratory support. This study suggests that umbilical cord milking appears to be a safe therapy when acidosis is present and when resuscitation is needed.
OBJECTIVE: To determine if umbilical cord milking is detrimental in compromised term/near-term infants. STUDY DESIGN: A retrospective analysis of infants with abnormal cord gases (cord arterial or venous pH of ≤ 7.1 or base deficit > -12). We collected maternal risk factors, cord management, birth, and neonatal outcomes during hospitalization. RESULT: We found 157 infants who met the criteria for abnormal cord gases. Thirty-six of those had umbilical cord milking at delivery. There was no significant difference in neonatal outcomes, but fewer infants in the cord milking group needed resuscitation (38 vs. 56%, p = 0.07) and ongoing respiratory support (19 vs. 31%, p = 0.16) compared to the immediate clamping group. CONCLUSIONS: While not significant, infants who received cord milking at birth needed less resuscitation and ongoing respiratory support. This study suggests that umbilical cord milking appears to be a safe therapy when acidosis is present and when resuscitation is needed.