Delayed versus Early Umbilical Cord Clamping in Preterm Multiple Gestation: A Randomized Controlled Trial.

IF 1.4 4区医学 Q3 OBSTETRICS & GYNECOLOGY

American journal of perinatology Pub Date : 2026-10-01 Epub Date: 2026-04-21 DOI:10.1055/a-2849-8087

Umesh Sharma, Anitha Ananthan, Haribalakrishna Balasubramanian, Prashanth Raghavendra, Muthu Vijayanathan, Padmaja Samant

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引用次数: 0

Abstract

Objective: The objective of this study is to evaluate the effects of delayed cord clamping (DCC) on hematocrit at 6 hours and 6 weeks of age, hospital stay, and other clinical outcomes at discharge.

Study design: This randomized controlled trial was conducted in a tertiary care center in Western India. Preterm multiple gestations were randomized to DCC at 60 seconds of birth or early cord clamping (ECC) within 30 seconds of birth. The primary outcome was hematocrit at 6 hours of age.

Results: A total of 76 mothers and 155 preterm infants of multiple gestation (73 twins and 3 triplets) were randomized. The mean hematocrit at 6 hours was significantly higher in the DCC group (61.9 ± 5.5 vs. 55.8 ± 5.3, N = 155, p < 0.001). Hematocrit at 6 weeks was also significantly higher in the DCC group (55.5 ± 3.8 vs. 49.6 ± 4.5, N = 142, p < 0.001). DCC adherence rate was 88% (n = 70) in the intervention group. Mortality was observed in six infants in the DCC group (7.5%) and eight infants (11%) in the ECC group. Infants in the DCC group had a higher peak bilirubin level, although not statistically significant (13.1 ± 2.3 vs. 11.1 ± 2.5 mg/dL, p = 0.09) and significantly prolonged duration of phototherapy (93.6 ± 32.8 vs. 61.4 ± 38.6 hours, p < 0.001). Other secondary outcomes were similar between the two groups.

Conclusion: DCC was feasible in preterm multiple gestation and resulted in improved hematocrit at 6 hours and 6 weeks of life. There was a nonsignificant trend toward higher peak bilirubin levels in infants who received DCC. This trial is registered with the Clinical Trials Registry of India (identifier: CTRI/2023/10/058944).

Key points: · DCC increased hematocrit at 6 hours and 6 weeks in preterm multiple gestation.. · DCC increased peak bilirubin levels and prolonged the duration of phototherapy.. · DCC is feasible in preterm multiple gestation..

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早产多胎妊娠延迟与早期脐带夹紧：一项随机对照试验。

目的：本研究的目的是评估延迟脐带夹紧（DCC）对6小时和6周龄时红细胞压积、住院时间和出院时其他临床结果的影响。研究设计：本随机对照试验在印度西部的一家三级保健中心进行。早产多胎妊娠随机分为出生后60秒DCC组或出生后30秒早期脐带夹紧组（ECC）。主要结果是6小时时的红细胞压积。结果：随机选取76例母亲和155例多胎早产儿，其中双胞胎73例，三胞胎3例。DCC组6小时平均红细胞压积明显高于干预组（61.9±5.5比55.8±5.3,N = 155, p = 142, p = 70）。DCC组有6名婴儿死亡（7.5%），ECC组有8名婴儿死亡（11%）。DCC组婴儿的峰值胆红素水平较高，但无统计学意义（13.1±2.3 vs 11.1±2.5 mg/dL, p = 0.09），且光疗持续时间显著延长（93.6±32.8 vs 61.4±38.6 h, p）。结论：DCC在早产多胎妊娠中是可行的，可在6小时和6周时改善红细胞压积。在接受DCC的婴儿中，胆红素峰值水平升高的趋势不显著。该试验已在印度临床试验注册中心注册（标识符：CTRI/2023/10/058944）。·DCC在早产多胎妊娠6小时和6周时增加红细胞压积。·DCC增加峰值胆红素水平，延长光疗持续时间。·DCC在早产多胎妊娠中是可行的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of perinatology 医学-妇产科学

CiteScore

5.90

自引率

0.00%

发文量

302

审稿时长

4-8 weeks

期刊介绍： The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields. The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field. All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication. The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.