Judith Gomersall1, Slavica Berber2, Philippa Middleton3, Susan J McDonald4, Susan Niermeyer5, Walid El-Naggar6, Peter G Davis7, Georg M Schmölzer8, Colleen Ovelman9, Roger F Soll9. 1. Women and Children's Hospital, South Australian Health and Medical Research Institute and The University of Adelaide, Adelaide, South Australia, Australia; judith.gomersall@adelaide.edu.au. 2. Cochrane Breast Cancer Group, Systematic Reviews and Health Technology Assessments National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia. 3. Women and Children's Hospital, South Australian Health and Medical Research Institute and The University of Adelaide, Adelaide, South Australia, Australia. 4. Midwifery Professorial Unit, La Trobe University and Mercy Hospital for Women, Melbourne, Victoria, Australia. 5. Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine. 6. Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada. 7. Newborn Research Centre, The Royal Women's Hospital and The University of Melbourne, Melbourne, Victoria, Australia. 8. Division of Neonatology, Department of Pediatrics, Medical University Graz, Graz, Austria; and. 9. Department of Pediatrics, The Robert Larner College of Medicine, The University of Vermont, Burlington, Vermont.
Abstract
CONTEXT: The International Liaison Committee on Resuscitation prioritized scientific review of umbilical cord management at term and late preterm birth. OBJECTIVE: To assess effects of umbilical cord management strategies (clamping timing and cord milking) in infants ≥34 weeks' gestational age. DATA SOURCES: Cochrane Central Register of Controlled Trials, Medline, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and trial registries searched July 2019. STUDY SELECTION: Two authors independently assessed eligibility of randomized controlled trials. DATA EXTRACTION: Two authors independently extracted data and assessed evidence certainty (Grading of Recommendations Assessment, Development and Evaluations). RESULTS: We identified 46 studies (9159 women and their infants) investigating 7 comparisons. Compared with early cord clamping (ECC) <30 seconds, delayed cord clamping (DCC) ≥30 seconds (33 studies), intact-cord milking (1 study), and cut-cord milking (2 studies) probably improve hematologic measures but may not affect survival without neurodisability, anemia in early infancy, or maternal postpartum hemorrhage. No differences in major neonatal morbidities are seen in studies comparing methods of optimizing placental transfusion (DCC versus cut-cord milking [3 studies], longer delays in clamping [7 studies], or physiologic parameters [3 studies]). Strategies that promote increased placental transfusion may be associated with greater phototherapy use. Evidence for all outcomes was low or very low certainty. LIMITATIONS: Incompleteness and low certainty of findings limit applicability. CONCLUSIONS: Compared with ECC, DCC or cord milking increases hemoglobin and hematocrit immediately after birth in infants ≥34 weeks' gestational age. The uncertain effects of DCC and cord milking compared with ECC on major morbidities limit usefulness of available evidence for policy and practice.
CONTEXT: The International Liaison Committee on Resuscitation prioritized scientific review of umbilical cord management at term and late preterm birth. OBJECTIVE: To assess effects of umbilical cord management strategies (clamping timing and cord milking) in infants ≥34 weeks' gestational age. DATA SOURCES: Cochrane Central Register of Controlled Trials, Medline, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and trial registries searched July 2019. STUDY SELECTION: Two authors independently assessed eligibility of randomized controlled trials. DATA EXTRACTION: Two authors independently extracted data and assessed evidence certainty (Grading of Recommendations Assessment, Development and Evaluations). RESULTS: We identified 46 studies (9159 women and their infants) investigating 7 comparisons. Compared with early cord clamping (ECC) <30 seconds, delayed cord clamping (DCC) ≥30 seconds (33 studies), intact-cord milking (1 study), and cut-cord milking (2 studies) probably improve hematologic measures but may not affect survival without neurodisability, anemia in early infancy, or maternal postpartum hemorrhage. No differences in major neonatal morbidities are seen in studies comparing methods of optimizing placental transfusion (DCC versus cut-cord milking [3 studies], longer delays in clamping [7 studies], or physiologic parameters [3 studies]). Strategies that promote increased placental transfusion may be associated with greater phototherapy use. Evidence for all outcomes was low or very low certainty. LIMITATIONS: Incompleteness and low certainty of findings limit applicability. CONCLUSIONS: Compared with ECC, DCC or cord milking increases hemoglobin and hematocrit immediately after birth in infants ≥34 weeks' gestational age. The uncertain effects of DCC and cord milking compared with ECC on major morbidities limit usefulness of available evidence for policy and practice.
Authors: Natalie Batey; Caroline Henry; Shalabh Garg; Michael Wagner; Atul Malhotra; Michel Valstar; Thomas Smith; Don Sharkey Journal: Pediatr Res Date: 2022-03-03 Impact factor: 3.756
Authors: Myra H Wyckoff; Eunice M Singletary; Jasmeet Soar; Theresa M Olasveengen; Robert Greif; Helen G Liley; David Zideman; Farhan Bhanji; Lars W Andersen; Suzanne R Avis; Khalid Aziz; Jason C Bendall; David C Berry; Vere Borra; Bernd W Böttiger; Richard Bradley; Janet E Bray; Jan Breckwoldt; Jestin N Carlson; Pascal Cassan; Maaret Castrén; Wei-Tien Chang; Nathan P Charlton; Adam Cheng; Sung Phil Chung; Julie Considine; Daniela T Costa-Nobre; Keith Couper; Katie N Dainty; Peter G Davis; Maria Fernanda de Almeida; Allan R de Caen; Edison F de Paiva; Charles D Deakin; Therese Djärv; Matthew J Douma; Ian R Drennan; Jonathan P Duff; Kathryn J Eastwood; Walid El-Naggar; Jonathan L Epstein; Raffo Escalante; Jorge G Fabres; Joe Fawke; Judith C Finn; Elizabeth E Foglia; Fredrik Folke; Karoline Freeman; Elaine Gilfoyle; Craig A Goolsby; Amy Grove; Ruth Guinsburg; Tetsuo Hatanaka; Mary Fran Hazinski; George S Heriot; Karen G Hirsch; Mathias J Holmberg; Shigeharu Hosono; Ming-Ju Hsieh; Kevin K C Hung; Cindy H Hsu; Takanari Ikeyama; Tetsuya Isayama; Vishal S Kapadia; Mandira Daripa Kawakami; Han-Suk Kim; David A Kloeck; Peter J Kudenchuk; Anthony T Lagina; Kasper G Lauridsen; Eric J Lavonas; Andrew S Lockey; Carolina Malta Hansen; David Markenson; Tasuku Matsuyama; Christopher J D McKinlay; Amin Mehrabian; Raina M Merchant; Daniel Meyran; Peter T Morley; Laurie J Morrison; Kevin J Nation; Michael Nemeth; Robert W Neumar; Tonia Nicholson; Susan Niermeyer; Nikolaos Nikolaou; Chika Nishiyama; Brian J O'Neil; Aaron M Orkin; Osokogu Osemeke; Michael J Parr; Catherine Patocka; Jeffrey L Pellegrino; Gavin D Perkins; Jeffrey M Perlman; Yacov Rabi; Joshua C Reynolds; Giuseppe Ristagno; Charles C Roehr; Tetsuya Sakamoto; Claudio Sandroni; Taylor Sawyer; Georg M Schmölzer; Sebastian Schnaubelt; Federico Semeraro; Markus B Skrifvars; Christopher M Smith; Michael A Smyth; Roger F Soll; Takahiro Sugiura; Sian Taylor-Phillips; Daniele Trevisanuto; Christian Vaillancourt; Tzong-Luen Wang; Gary M Weiner; Michelle Welsford; Jane Wigginton; Jonathan P Wyllie; Joyce Yeung; Jerry P Nolan; Katherine M Berg Journal: Resuscitation Date: 2021-11-11 Impact factor: 5.262
Authors: John Madar; Charles C Roehr; Sean Ainsworth; Hege Ersda; Colin Morley; Mario Rüdiger; Christiane Skåre; Tomasz Szczapa; Arjan Te Pas; Daniele Trevisanuto; Berndt Urlesberger; Dominic Wilkinson; Jonathan P Wyllie Journal: Notf Rett Med Date: 2021-06-02 Impact factor: 0.892