Neurodevelopmental Outcomes of Very Low Birth Weight Infants Following Extrauterine Placental Perfusion: A Follow-Up Study.

Aim: Extrauterine placental perfusion (EPP) may be a feasible cord clamping strategy in very low birth weight (VLBW) infants to support neonatal transition. However, the impact of EPP on neurodevelopment remains unclear. The study aimed to compare the effects of EPP with time-based delayed cord clamping (DCC) on neurodevelopmental outcomes.

Methods: This follow-up study of the randomised controlled EXPLAIN (Extrauterine Placental Transfusion in Resuscitation of Very Low Birth Weight Infants) trial (ClinicalTrials.gov Identifier: NCT03916159) was conducted at a tertiary perinatal centre from 2021 to 2023. Antenatally randomised VLBW infants received either EPP or DCC (> 30 s). Neurodevelopment was assessed at 24 months of corrected age using the Bayley Scales of Infant and Toddler Development, Third Edition. Data analysis was intention-to-treat.

Results: Of 59 infants enrolled, 54 (92%) participated in the follow-up (27 EPP, 27 DCC). Median age at assessment was 24.3 months (range 23.5-25.0); 28 (52%) were male. Infant characteristics and short-term outcomes were similar between groups. No relevant differences were observed in median cognitive, motor or language scores or in rates of cerebral palsy, hearing, or visual impairment.

Conclusion: The neurodevelopment of the VLBW infants who received EPP and DCC was comparable, suggesting that EPP may be a viable alternative.