Jinrong Li1,2, Sufei Yang1,2, Fan Yang1,2, Jinhui Wu1,2, Fei Xiong1,2. 1. Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, China. 2. Key laboratory of birth defects and related diseases of women and children, Sichuan University, Chengdu, 610041, China.
Abstract
BACKGROUND: To compare and evaluate the efficacy and safety of immediate cord clamping (ICC) and delayed cord clamping (DCC) in preterm infants. METHODS: We performed a comprehensive and systematic meta-analysis of randomized controlled trials (RCTs) assessing ICC and DCC in preterm infants by searching PUBMED, EMBASE, Science Direct, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, and Wanfang Database (from inception to Sept 30, 2020). Summary odds ratios or mean differences with 95% confidence intervals were calculated using a fixed- or random-effect model. RESULTS: A total of 20 RCTs with 1807 preterm infants were included in the study. DCC provided more benefits in increasing the hematocrit and hemoglobin levels at 24 h of life (%), thus reducing the incidence of anemia, necrotizing enterocolitis, length of hospital stay, and mortality than when ICC was performed. No significant differences were found between ICC and DCC in terms of peak bilirubin level; need for blood transfusion, mechanical ventilation (MV), and phototherapy; duration of MV and phototherapy; and incidences of intraventricular hemorrhage, retinopathy of prematurity, patent ductus arteriosus, respiratory distress syndrome, sepsis, jaundice, polycythemia, periventricular leukomalacia, and bronchopulmonary dysplasia. CONCLUSION: DCC is a safe, beneficial, and feasible intervention for preterm infants. However, rigorously designed and large-scale RCTs are necessary to identify the role and ideal timing of DCC. This article is protected by copyright. All rights reserved.
BACKGROUND: To compare and evaluate the efficacy and safety of immediate cord clamping (ICC) and delayed cord clamping (DCC) in preterm infants. METHODS: We performed a comprehensive and systematic meta-analysis of randomized controlled trials (RCTs) assessing ICC and DCC in preterm infants by searching PUBMED, EMBASE, Science Direct, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, and Wanfang Database (from inception to Sept 30, 2020). Summary odds ratios or mean differences with 95% confidence intervals were calculated using a fixed- or random-effect model. RESULTS: A total of 20 RCTs with 1807 preterm infants were included in the study. DCC provided more benefits in increasing the hematocrit and hemoglobin levels at 24 h of life (%), thus reducing the incidence of anemia, necrotizing enterocolitis, length of hospital stay, and mortality than when ICC was performed. No significant differences were found between ICC and DCC in terms of peak bilirubin level; need for blood transfusion, mechanical ventilation (MV), and phototherapy; duration of MV and phototherapy; and incidences of intraventricular hemorrhage, retinopathy of prematurity, patent ductus arteriosus, respiratory distress syndrome, sepsis, jaundice, polycythemia, periventricular leukomalacia, and bronchopulmonary dysplasia. CONCLUSION:DCC is a safe, beneficial, and feasible intervention for preterm infants. However, rigorously designed and large-scale RCTs are necessary to identify the role and ideal timing of DCC. This article is protected by copyright. All rights reserved.
Authors: Katarzyna Kosińska-Kaczyńska; Jacek Witwicki; Aleksandra Saletra-Bielińska; Paweł Krajewski; Adam Krysiak; Robert Brawura-Biskupski-Samaha; Izabela Walasik; Magdalena Zgliczyńska; Ewa Malicka; Iwona Szymusik Journal: BMC Pregnancy Childbirth Date: 2022-08-05 Impact factor: 3.105