Delayed versus immediate cord clamping in preterm infants

Journal article


Tarnow-Mordi, W., Morris, J., Kirby, Adrienne, Robledo, Kristy, Askie, Lisa, Brown, Rebecca, Evans, Nicholas, Finlayson, Sarah, Fogarty, Michael, Gebski, Val, Ghadge, Alpana, Hague, Wendy, Isaacs, David, Jeffery, Michele, Keech, Anthony C., Kluckow, Martin, Popat, Himanshu P., Sebastian, Lucille, Aagaard, Kjersti M., ... Simes, John. (2017). Delayed versus immediate cord clamping in preterm infants. New England Journal of Medicine. 377(5), pp. 2445 - 2455. https://doi.org/10.1056/NEJMoa1711281
AuthorsTarnow-Mordi, W., Morris, J., Kirby, Adrienne, Robledo, Kristy, Askie, Lisa, Brown, Rebecca, Evans, Nicholas, Finlayson, Sarah, Fogarty, Michael, Gebski, Val, Ghadge, Alpana, Hague, Wendy, Isaacs, David, Jeffery, Michele, Keech, Anthony C., Kluckow, Martin, Popat, Himanshu P., Sebastian, Lucille, Aagaard, Kjersti M., Belfort, Michael, Pammi, Mohan, Abdel-Latif, Mohamed, Reynolds, Graham, Ariff, Shabina, Sheikh, Lumaan, Chen, Yan, Colditz, Paul, Liley, Helen, Pritchard, Margo, de Luca, Daniele, de Waal, Koert, Forder, Peta, Biostat, M., Duley, Lelia, El-Naggar, Walid, Gill, Andrew, Newnham, John, Simmer, Karen, Groom, Katie, Weston, Philip, Gullam, Joanna, Patel, Harshad, Koh, Guan, Lui, Kei, Marlow, Neil, Morris, Scott, Sehgal, Arvind, Wallace, Euan, Soll, Roger, Young, Leslie, Sweet, David, Walker, Susan, Watkins, Andrew, Wright, Ian, Osborn, David and Simes, John
Abstract

Background: The preferred timing of umbilical-cord clamping in preterm infants is unclear. Methods: We randomly assigned fetuses from women who were expected to deliver before 30 weeks of gestation to either immediate clamping of the umbilical cord (≤10 seconds after delivery) or delayed clamping (≥60 seconds after delivery). The primary composite outcome was death or major morbidity (defined as severe brain injury on postnatal ultrasonography, severe retinopathy of prematurity, necrotizing enterocolitis, or late-onset sepsis) by 36 weeks of postmenstrual age. Analyses were performed on an intention-to-treat basis, accounting for multiple births. Results: Of 1634 fetuses that underwent randomization, 1566 were born alive before 30 weeks of gestation; of these, 782 were assigned to immediate cord clamping and 784 to delayed cord clamping. The median time between delivery and cord clamping was 5 seconds and 60 seconds in the respective groups. Complete data on the primary outcome were available for 1497 infants (95.6%). There was no significant difference in the incidence of the primary outcome between infants assigned to delayed clamping (37.0%) and those assigned to immediate clamping (37.2%) (relative risk, 1.00; 95% confidence interval, 0.88 to 1.13; P=0.96). The mortality was 6.4% in the delayed-clamping group and 9.0% in the immediate-clamping group (P=0.03 in unadjusted analyses; P=0.39 after post hoc adjustment for multiple secondary outcomes). There were no significant differences between the two groups in the incidences of chronic lung disease or other major morbidities. Conclusions: Among preterm infants, delayed cord clamping did not result in a lower incidence of the combined outcome of death or major morbidity at 36 weeks of gestation than immediate cord clamping. (Funded by the Australian National Health and Medical Research Council [NHMRC] and the NHMRC Clinical Trials Centre; APTS Australian and New Zealand Clinical Trials Registry number, ACTRN12610000633088. opens in new tab.)

Year2017
JournalNew England Journal of Medicine
Journal citation377 (5), pp. 2445 - 2455
PublisherNEJM
ISSN1533-4406
Digital Object Identifier (DOI)https://doi.org/10.1056/NEJMoa1711281
Scopus EID2-s2.0-85039784916
Page range2445 - 2455
Research GroupSchool of Nursing, Midwifery and Paramedicine
Publisher's version
File Access Level
Controlled
Place of publicationUnited States of America
Permalink -

https://acuresearchbank.acu.edu.au/item/8q4xv/delayed-versus-immediate-cord-clamping-in-preterm-infants

Restricted files

Publisher's version

  • 93
    total views
  • 0
    total downloads
  • 2
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

A randomized trial of baby triple p for preterm infants: Child outcomes at 2 years of corrected age
Colditz, Paul B., Boyd, Roslyn N., Winter, Leanne, Pritchard, Margo, Gray, Peter H., Whittingham, Koa, O'Callaghan, Michael, Jardine, Luke, O'Rourke, Peter, Marquart, Louise, Forrest, Kylee, Spry, Carmen and Sanders, Matthew R.. (2019). A randomized trial of baby triple p for preterm infants: Child outcomes at 2 years of corrected age. Journal of Pediatrics. 210, pp. 48 - 54. https://doi.org/10.1016/j.jpeds.2019.01.024
Social-emotional development in very preterm infants during early infancy
Gray, Peter H., Edwards, Dawn M., Hughes, Ian P. and Pritchard, Margo. (2018). Social-emotional development in very preterm infants during early infancy. Early Human Development. 121, pp. 44 - 48. https://doi.org/10.1016/j.earlhumdev.2018.05.002
Predicting attendance of a preventive parenting intervention for very preterm infants
Winter, Leanne, Sanders, Matthew R., Boyd, Roslyn N., Pritchard, Margo, Gray, Peter H., Whittingham, Koa, Forrest, Kylee, Webb, Lachlan, Marquart, Louise and Colditz, Paul B.. (2018). Predicting attendance of a preventive parenting intervention for very preterm infants. Infant Mental Health Journal. 39(6), pp. 699 - 706. https://doi.org/10.1002/imhj.21749
Depression, posttraumatic stress and relationship distress in parents of very preterm infants
Winter, Leanne, Colditz, Paul B., Sanders, Matthew R., Boyd, Roslyn N., Pritchard, Margo, Gray, Peter H., Whittingham, Koa, Forrest, Kylee, Leeks, Rebecca, Webb, Lachlan, Marquart, Louise, Taylor, Karen and Macey, Judith. (2018). Depression, posttraumatic stress and relationship distress in parents of very preterm infants. Archives of Women's Mental Health. 21, pp. 445 - 451. https://doi.org/10.1007/s00737-018-0821-6
Early maternal reflective functioning and infant emotional regulation in a preterm infant sample at 6 months corrected age
Heron-Delaney, Michelle, Kenardy, Justin, Brown, Erin, Jardin, Chloe, Bogossian, Fiona Elizabeth, Neuman, Louise, de Dassel, Therese and Pritchard, Margo. (2016). Early maternal reflective functioning and infant emotional regulation in a preterm infant sample at 6 months corrected age. Journal of Pediatric Psychology. 41(8), pp. 906 - 914. https://doi.org/10.1093/jpepsy/jsv169
Nasal high-flow therapy for primary respiratory support in preterm infants
Roberts, Calum T., Owen, Louise S., Manley, Brett J., Frøisland, Dag H., Donath, Susan M., Dalziel, Kim M., Pritchard, Margo, Cartwright, David W., Collins, Clare L., Malhotra, Atul and Davis, Peter G.. (2016). Nasal high-flow therapy for primary respiratory support in preterm infants. New England Journal of Medicine. 375(12), pp. 1142 - 1151. https://doi.org/10.1056/NEJMoa1603694
Autism in toddlers born very preterm
Pritchard, Margo, De Dassel, Therese, Beller, Elaine Mary, Bogossian, Fiona Elizabeth, Johnston, Linda, Paynter, Jessica, Russo, Santo and Scott, James Paul. (2016). Autism in toddlers born very preterm. Pediatrics. 137(2), pp. 1 - 10. https://doi.org/10.1542/peds.2015-1949
Prem Baby Triple P: a randomised controlled trial of enhanced parenting capacity to improve developmental outcomes in preterm infants
Colditz, Paul, Sanders, Matthew R., Boyd, Roslyn, Pritchard, Margo, Grey, Peter, O'Callaghan, Michael J., Slaughter, Virginia, Whittingham, Koa, O'Rourke, Peter, Winter, Leanne, Evans, Tracey, Herd, Michael, Ahern, Jessica and Jardine, Luke. (2015). Prem Baby Triple P: a randomised controlled trial of enhanced parenting capacity to improve developmental outcomes in preterm infants. BMC Pediatrics. 15(15), pp. 1 - 13. https://doi.org/10.1186/s12887-015-0331-x
The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review
Staneva, Aleksandra, Bogossian, Fiona, Pritchard, Margo, Wittkowski, Anja and Anja, . (2015). The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review. Women and Birth. 28(3), pp. 179 - 193. https://doi.org/10.1016/j.wombi.2015.02.003
High-flow nasal cannulae in very preterm infants after extubation
Manley, Brett J., Owen, Louise S., Doyle, Lex, Anderson, Chad, Cartwright, David, Pritchard, Margo, Donath, Susan and Davis, Peter. (2013). High-flow nasal cannulae in very preterm infants after extubation. New England Journal of Medicine. 369(15), pp. 1425 - 1433. https://doi.org/10.1056/NEJMoa1300071