Christina E Rodriguez1,2, Torri D Metz2,3, Shrena Patel4, Minda Abbaszadeh4, Bradley A Yoder4, Tyler Bardsley5, Erin A S Clark1. 1. Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah. 2. Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado. 3. Department of Obstetrics and Gynecology, Denver Health and Hospital Authority, Denver, Colorado. 4. Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah. 5. Study Design and Biostatistics Center, University of Utah, Salt Lake City, Utah.
Abstract
OBJECTIVE: Our aim was to evaluate the effect of umbilical cord milking on outcomes for preterm multiples. STUDY DESIGN: We implemented a policy of cord milking in neonates born at less than 30 weeks' gestation in September 2011. We compared cord milking in multiples with a historical cohort. Multivariable logistic regression models estimated the effect of cord milking on a composite neonatal adverse outcome. Secondary outcomes were hematocrit at birth, need for blood transfusion, and inotrope use. RESULTS: We identified 149 neonates (120 twins, 29 triplets), 51 historical controls, and 98 neonates with cord milking. Cord milking was associated with a lower rate of adverse composite neonatal outcome in univariable analysis (odds ratio [OR]: 0.36; 95% confidence interval [CI]: 0.15-0.84). However, in multivariable modeling, the effect was not significant (adjusted OR [aOR]: 0.54, 95% CI: 0.23-1.28). Hematocrit was 4.6 unit % (95% CI: 2-7.3) higher in the cord milking group, and cord milking was associated with a lower rate of blood transfusion (aOR: 0.28; 95% CI: 0.1-0.74; p = 0.01). There was no difference in inotrope administration. CONCLUSION: Umbilical cord milking was not associated with a decrease in composite neonatal adverse outcome. However, we observed an increase in hematocrit and decreased need for blood transfusion in neonates with cord milking. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: Our aim was to evaluate the effect of umbilical cord milking on outcomes for preterm multiples. STUDY DESIGN: We implemented a policy of cord milking in neonates born at less than 30 weeks' gestation in September 2011. We compared cord milking in multiples with a historical cohort. Multivariable logistic regression models estimated the effect of cord milking on a composite neonatal adverse outcome. Secondary outcomes were hematocrit at birth, need for blood transfusion, and inotrope use. RESULTS: We identified 149 neonates (120 twins, 29 triplets), 51 historical controls, and 98 neonates with cord milking. Cord milking was associated with a lower rate of adverse composite neonatal outcome in univariable analysis (odds ratio [OR]: 0.36; 95% confidence interval [CI]: 0.15-0.84). However, in multivariable modeling, the effect was not significant (adjusted OR [aOR]: 0.54, 95% CI: 0.23-1.28). Hematocrit was 4.6 unit % (95% CI: 2-7.3) higher in the cord milking group, and cord milking was associated with a lower rate of blood transfusion (aOR: 0.28; 95% CI: 0.1-0.74; p = 0.01). There was no difference in inotrope administration. CONCLUSION: Umbilical cord milking was not associated with a decrease in composite neonatal adverse outcome. However, we observed an increase in hematocrit and decreased need for blood transfusion in neonates with cord milking. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Neha Kumbhat; Barry Eggleston; Alexis S Davis; Krisa P Van Meurs; Sara Bonamo DeMauro; Elizabeth E Foglia; Satyanarayan Lakshminrusimha; Michele C Walsh; Kristi L Watterberg; Myra H Wyckoff; Abhik Das; Sara C Handley Journal: Arch Dis Child Fetal Neonatal Ed Date: 2020-07-30 Impact factor: 5.747