Benefits of umbilical cord milking versus delayed cord clamping on neonatal outcomes in preterm infants: A systematic review and meta-analysis
Background\nOptimum timing of umbilical cord clamping has not been established in preterm infants.\nObjectives\nWe compared the short- and long-term effects of umbilical cord milking (UCM) versus delayed cord clamping (DCC) on infants born at less than 37 weeks of gestation.\nSearch methods\nA syste...
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| Published in | PLOS ONE Vol. 13; no. 8; p. e0201528 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
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30.08.2018
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| Abstract | Background\nOptimum timing of umbilical cord clamping has not been established in preterm infants.\nObjectives\nWe compared the short- and long-term effects of umbilical cord milking (UCM) versus delayed cord clamping (DCC) on infants born at less than 37 weeks of gestation.\nSearch methods\nA systematic review and meta-analysis was conducted according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" statement. We searched CINAHL, CENTRAL, EMBASE, MEDLINE, PubMed and ClinicalTrials.gov for relevant randomized controlled trials (RCTs).\nSelection criteria\nWe included individual and clustered RCTs comparing UCM to DCC for infants born before 37 weeks of gestation.\nData collection and analysis\nFour reviewers independently assessed trial quality and eligibility for inclusion.\nMain results\nTwo trials (255 preterm infants, 23 0/7 to 32 6/7 weeks of gestation) were included in the analysis. UCM was associated with fewer intraventricular hemorrhages (IVHs) (two trials, 255 infants; relative risk [RR] 0.45, 95% confidence interval [CI] 0.20 to 0.98, low quality of evidence) and UCM was an increased proportion of infants with a Bayley score at 2 years of age (two trials, 174 infants; Cognitive: RR 1.14, 95% CI 1.03 to 1.26, Language: RR 1.24, 95% CI 1.03 to 1.49, low quality of evidence) compared to DCC.\nConclusions\nUCM wasn't reduced in-hospital mortality and need for transfusion compared to DCC. But our study suggests that UCM may lower the risk of IVH and improve certain neurodevelopmental outcomes compared to DCC in preterm infants. |
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| AbstractList | Optimum timing of umbilical cord clamping has not been established in preterm infants. We compared the short- and long-term effects of umbilical cord milking (UCM) versus delayed cord clamping (DCC) on infants born at less than 37 weeks of gestation. UCM wasn't reduced in-hospital mortality and need for transfusion compared to DCC. But our study suggests that UCM may lower the risk of IVH and improve certain neurodevelopmental outcomes compared to DCC in preterm infants. Optimum timing of umbilical cord clamping has not been established in preterm infants. We compared the short- and long-term effects of umbilical cord milking (UCM) versus delayed cord clamping (DCC) on infants born at less than 37 weeks of gestation. A systematic review and meta-analysis was conducted according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" statement. We searched CINAHL, CENTRAL, EMBASE, MEDLINE, PubMed and ClinicalTrials.gov for relevant randomized controlled trials (RCTs). We included individual and clustered RCTs comparing UCM to DCC for infants born before 37 weeks of gestation. Four reviewers independently assessed trial quality and eligibility for inclusion. Two trials (255 preterm infants, 23 0/7 to 32 6/7 weeks of gestation) were included in the analysis. UCM was associated with fewer intraventricular hemorrhages (IVHs) (two trials, 255 infants; relative risk [RR] 0.45, 95% confidence interval [CI] 0.20 to 0.98, low quality of evidence) and UCM was an increased proportion of infants with a Bayley score at 2 years of age (two trials, 174 infants; Cognitive: RR 1.14, 95% CI 1.03 to 1.26, Language: RR 1.24, 95% CI 1.03 to 1.49, low quality of evidence) compared to DCC. UCM wasn't reduced in-hospital mortality and need for transfusion compared to DCC. But our study suggests that UCM may lower the risk of IVH and improve certain neurodevelopmental outcomes compared to DCC in preterm infants. Background Optimum timing of umbilical cord clamping has not been established in preterm infants. Objectives We compared the short- and long-term effects of umbilical cord milking (UCM) versus delayed cord clamping (DCC) on infants born at less than 37 weeks of gestation. Search methods A systematic review and meta-analysis was conducted according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" statement. We searched CINAHL, CENTRAL, EMBASE, MEDLINE, PubMed and ClinicalTrials.gov for relevant randomized controlled trials (RCTs). Selection criteria We included individual and clustered RCTs comparing UCM to DCC for infants born before 37 weeks of gestation. Data collection and analysis Four reviewers independently assessed trial quality and eligibility for inclusion. Main results Two trials (255 preterm infants, 23 0/7 to 32 6/7 weeks of gestation) were included in the analysis. UCM was associated with fewer intraventricular hemorrhages (IVHs) (two trials, 255 infants; relative risk [RR] 0.45, 95% confidence interval [CI] 0.20 to 0.98, low quality of evidence) and UCM was an increased proportion of infants with a Bayley score at 2 years of age (two trials, 174 infants; Cognitive: RR 1.14, 95% CI 1.03 to 1.26, Language: RR 1.24, 95% CI 1.03 to 1.49, low quality of evidence) compared to DCC. Conclusions UCM wasn't reduced in-hospital mortality and need for transfusion compared to DCC. But our study suggests that UCM may lower the risk of IVH and improve certain neurodevelopmental outcomes compared to DCC in preterm infants. Background\nOptimum timing of umbilical cord clamping has not been established in preterm infants.\nObjectives\nWe compared the short- and long-term effects of umbilical cord milking (UCM) versus delayed cord clamping (DCC) on infants born at less than 37 weeks of gestation.\nSearch methods\nA systematic review and meta-analysis was conducted according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" statement. We searched CINAHL, CENTRAL, EMBASE, MEDLINE, PubMed and ClinicalTrials.gov for relevant randomized controlled trials (RCTs).\nSelection criteria\nWe included individual and clustered RCTs comparing UCM to DCC for infants born before 37 weeks of gestation.\nData collection and analysis\nFour reviewers independently assessed trial quality and eligibility for inclusion.\nMain results\nTwo trials (255 preterm infants, 23 0/7 to 32 6/7 weeks of gestation) were included in the analysis. UCM was associated with fewer intraventricular hemorrhages (IVHs) (two trials, 255 infants; relative risk [RR] 0.45, 95% confidence interval [CI] 0.20 to 0.98, low quality of evidence) and UCM was an increased proportion of infants with a Bayley score at 2 years of age (two trials, 174 infants; Cognitive: RR 1.14, 95% CI 1.03 to 1.26, Language: RR 1.24, 95% CI 1.03 to 1.49, low quality of evidence) compared to DCC.\nConclusions\nUCM wasn't reduced in-hospital mortality and need for transfusion compared to DCC. But our study suggests that UCM may lower the risk of IVH and improve certain neurodevelopmental outcomes compared to DCC in preterm infants. Optimum timing of umbilical cord clamping has not been established in preterm infants.BACKGROUNDOptimum timing of umbilical cord clamping has not been established in preterm infants.We compared the short- and long-term effects of umbilical cord milking (UCM) versus delayed cord clamping (DCC) on infants born at less than 37 weeks of gestation.OBJECTIVESWe compared the short- and long-term effects of umbilical cord milking (UCM) versus delayed cord clamping (DCC) on infants born at less than 37 weeks of gestation.A systematic review and meta-analysis was conducted according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" statement. We searched CINAHL, CENTRAL, EMBASE, MEDLINE, PubMed and ClinicalTrials.gov for relevant randomized controlled trials (RCTs).SEARCH METHODSA systematic review and meta-analysis was conducted according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" statement. We searched CINAHL, CENTRAL, EMBASE, MEDLINE, PubMed and ClinicalTrials.gov for relevant randomized controlled trials (RCTs).We included individual and clustered RCTs comparing UCM to DCC for infants born before 37 weeks of gestation.SELECTION CRITERIAWe included individual and clustered RCTs comparing UCM to DCC for infants born before 37 weeks of gestation.Four reviewers independently assessed trial quality and eligibility for inclusion.DATA COLLECTION AND ANALYSISFour reviewers independently assessed trial quality and eligibility for inclusion.Two trials (255 preterm infants, 23 0/7 to 32 6/7 weeks of gestation) were included in the analysis. UCM was associated with fewer intraventricular hemorrhages (IVHs) (two trials, 255 infants; relative risk [RR] 0.45, 95% confidence interval [CI] 0.20 to 0.98, low quality of evidence) and UCM was an increased proportion of infants with a Bayley score at 2 years of age (two trials, 174 infants; Cognitive: RR 1.14, 95% CI 1.03 to 1.26, Language: RR 1.24, 95% CI 1.03 to 1.49, low quality of evidence) compared to DCC.MAIN RESULTSTwo trials (255 preterm infants, 23 0/7 to 32 6/7 weeks of gestation) were included in the analysis. UCM was associated with fewer intraventricular hemorrhages (IVHs) (two trials, 255 infants; relative risk [RR] 0.45, 95% confidence interval [CI] 0.20 to 0.98, low quality of evidence) and UCM was an increased proportion of infants with a Bayley score at 2 years of age (two trials, 174 infants; Cognitive: RR 1.14, 95% CI 1.03 to 1.26, Language: RR 1.24, 95% CI 1.03 to 1.49, low quality of evidence) compared to DCC.UCM wasn't reduced in-hospital mortality and need for transfusion compared to DCC. But our study suggests that UCM may lower the risk of IVH and improve certain neurodevelopmental outcomes compared to DCC in preterm infants.CONCLUSIONSUCM wasn't reduced in-hospital mortality and need for transfusion compared to DCC. But our study suggests that UCM may lower the risk of IVH and improve certain neurodevelopmental outcomes compared to DCC in preterm infants. |
| Audience | Academic |
| Author | Ota Erika Sugiura Takahiro Saito Makoto 齋藤 誠 Miyahara Fumiko Namba Fumihiko Nagano Nobuhiko |
| AuthorAffiliation | 6 Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, Chuo, Tokyo, Japan RCSI & UCD Malaysia Campus (formerly Penang Medical College), MALAYSIA 2 Department of Pediatrics, University of Tsukuba, Tsukuba, Ibaraki, Japan 5 Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama Japan 1 Department of Pediatrics and Child Health, Nihon University School of Medicine, Itabashi, Tokyo, Japan 4 Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Tottori, Japan 3 Department of Pediatrics, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan |
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| Snippet | Background\nOptimum timing of umbilical cord clamping has not been established in preterm infants.\nObjectives\nWe compared the short- and long-term effects of... Optimum timing of umbilical cord clamping has not been established in preterm infants. We compared the short- and long-term effects of umbilical cord milking... Background Optimum timing of umbilical cord clamping has not been established in preterm infants. Objectives We compared the short- and long-term effects of... Optimum timing of umbilical cord clamping has not been established in preterm infants. We compared the short- and long-term effects of umbilical cord milking... Optimum timing of umbilical cord clamping has not been established in preterm infants.BACKGROUNDOptimum timing of umbilical cord clamping has not been... BACKGROUND:Optimum timing of umbilical cord clamping has not been established in preterm infants. OBJECTIVES:We compared the short- and long-term effects of... |
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| SubjectTerms | Biology and Life Sciences Health aspects Medicine and Health Sciences Meta-analysis Premature infants Research and Analysis Methods Umbilical cord |
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| Title | Benefits of umbilical cord milking versus delayed cord clamping on neonatal outcomes in preterm infants: A systematic review and meta-analysis |
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