Finn, D;Ryan, DH;Pavel, A;O'Toole, JM;Livingstone, V;Boylan, GB;Kenny, LC;Dempsey, EM

2019

May

Journal of Pediatrics

Clamping the Umbilical Cord in Premature Deliveries (CUPiD): Neuromonitoring in the Immediate Newborn Period in a Randomized, Controlled Trial of Preterm Infants Born at < 32 Weeks of Gestation

Validated

WOS: 18 ()

IMPROVES NEONATAL ADAPTATION CEREBRAL OXYGEN-SATURATION RED-CELL TRANSFUSIONS PLACENTAL TRANSFUSION BIRTH NEED LIFE

208

121

Objective To compare cerebral activity and oxygenation in preterm infants (<32 weeks of gestation) randomized to different cord clamping strategies. Study design Preterminfants born at <32 weeks of gestation were randomized to immediate cord clamping, umbilical cord milking (cord stripped 3 times), or delayed cord clamping for 60 seconds with bedside resuscitation. All infants underwent electroencephalogram (EEG) and cerebral near infrared spectroscopy for the first 72 hours after birth. Neonatal primary outcome measures were quantitative measures of the EEG (17 features) and near infrared spectroscopy over 1-hour time frames at 6 and 12 hours of life. Results Forty-five infants were recruited during the study period. Twelve infants (27%) were randomized to immediate cord clamping, 19 (42%) to umbilical cord milking, and 14 (31%) to delayed cord clamping with bedside resuscitation. There were no significant differences between groups for measures of EEG activity or cerebral near infrared spectroscopy. Three of the 45 infants (6.7%) were diagnosed with severe IVH (2 in the immediate cord clamping group, 1 in the umbilical cord milking group; P = .35). Conclusions There were no differences in cerebral EEG activity and cerebral oxygenation values between cord management strategies at 6 and 12 hours.

NEW YORK

0022-3476

10.1016/j.jpeds.2018.12.039