Mohammed Yunis1, Islam Nour1,2, Ahmed Gibreel3, Mohamad Darwish4, Mohamed Sarhan2,5, Basma Shouman1,2, Nehad Nasef6,7. 1. Neonatal Intensive Care Unit, Department of Pediatrics, Mansoura University Children's Hospital, Gomhoria Street, Mansoura, 35516, Egypt. 2. Department of Pediatrics, Faculty of Medicine, University of Mansoura, Mansoura, Egypt. 3. Department of Obstetrics and Gynecology, Faculty of Medicine, University of Mansoura, Mansoura, Egypt. 4. Department of Clinical Pathology, Faculty of Medicine, University of Mansoura, Mansoura, Egypt. 5. Hematology and Oncology Unit, Mansoura University Children's Hospital, Mansoura, Egypt. 6. Neonatal Intensive Care Unit, Department of Pediatrics, Mansoura University Children's Hospital, Gomhoria Street, Mansoura, 35516, Egypt. nehad_nasef@mans.edu.eg. 7. Department of Pediatrics, Faculty of Medicine, University of Mansoura, Mansoura, Egypt. nehad_nasef@mans.edu.eg.
Abstract
The feasibility of delayed cord clamping (DCC) in preterm infants with placental insufficiency (PI) is questionable. We aimed to study the effect of DCC on stem cell transfusion, hematological parameters, and clinical outcomes in preterm infants born to mothers with PI. Preterm infants, < 34 weeks' gestation, born to mothers with PI were randomized based on the timing of umbilical cord clamping into delayed clamping for 60 s (DCC group) or immediate cord clamping (ICC group) groups at time of birth. CD34 percentage as a marker of stem cell transfusion, early and late-onset anemia, hypothermia, hypotension, polycythemia, hyperbilirubinemia, duration of oxygen therapy, bronchopulmonary dysplasia, intra-ventricular hemorrhage, necrotizing enterocolitis, sepsis, mortality, and length of hospital stay were compared between studied groups. We found that peripheral blood CD34 percentage was significantly higher in DCC compared with that in the ICC group (median (IQR) of 0.5 (0.40-0.7) versus 0.35 (0.20-0.5), p = 0.004). Infants in the DCC group had significantly lower episodes of anemia of prematurity at 2 months, red blood cell transfusion, and shorter duration of oxygen therapy compared with those in the ICC group. Conclusion: In conclusion, DCC compared with ICC increased stem cell transfusion and decreased early- and late-onset anemia in preterm infants with placental insufficiency.Trial registration: NCT03731546 www.clinicaltrials.gov What is Known: • Delayed cord clamping has been recommended by the American Academy of Pediatrics as a standard of care practice during delivery of preterm infants. • The feasibility of DCC in preterm infants with placental insufficiency (PI) is uncertain. What is New: • This randomized controlled trial demonstrated that DCC in the delivery room care of preterm infants born to mothers with placental insufficiency increased stem cell transfusion and decreased early- and late-onset anemia.
The feasibility of delayed cord clamping (DCC) in preterm infants with placental insufficiency (PI) is questionable. We aimed to study the effect of DCC on stem cell transfusion, hematological parameters, and clinical outcomes in preterm infants born to mothers with PI. Preterm infants, < 34 weeks' gestation, born to mothers with PI were randomized based on the timing of umbilical cord clamping into delayed clamping for 60 s (DCC group) or immediate cord clamping (ICC group) groups at time of birth. CD34 percentage as a marker of stem cell transfusion, early and late-onset anemia, hypothermia, hypotension, polycythemia, hyperbilirubinemia, duration of oxygen therapy, bronchopulmonary dysplasia, intra-ventricular hemorrhage, necrotizing enterocolitis, sepsis, mortality, and length of hospital stay were compared between studied groups. We found that peripheral blood CD34 percentage was significantly higher in DCC compared with that in the ICC group (median (IQR) of 0.5 (0.40-0.7) versus 0.35 (0.20-0.5), p = 0.004). Infants in the DCC group had significantly lower episodes of anemia of prematurity at 2 months, red blood cell transfusion, and shorter duration of oxygen therapy compared with those in the ICC group. Conclusion: In conclusion, DCC compared with ICC increased stem cell transfusion and decreased early- and late-onset anemia in preterm infants with placental insufficiency.Trial registration: NCT03731546 www.clinicaltrials.gov What is Known: • Delayed cord clamping has been recommended by the American Academy of Pediatrics as a standard of care practice during delivery of preterm infants. • The feasibility of DCC in preterm infants with placental insufficiency (PI) is uncertain. What is New: • This randomized controlled trial demonstrated that DCC in the delivery room care of preterm infants born to mothers with placental insufficiency increased stem cell transfusion and decreased early- and late-onset anemia.
Authors: Mohammed Nagy; Nehad Nasef; Ahmed Gibreel; Mohamed Sarhan; Hoda Aldomiaty; Mohammed Darwish; Islam Nour Journal: Front Pediatr Date: 2022-03-04 Impact factor: 3.418
Authors: Alexander James Cleator; Emma Coombe; Vasiliki Alexopoulou; Laura Levingston; Kathryn Evans; Jonathan Christopher Hurst; Charles William Yoxall Journal: Children (Basel) Date: 2022-01-05