Delayed versus Immediate Cord Clamping in Preterm Infants

Tarnow-Mordi W et al, N Engl J Med. 2017 Dec

New born baby being treat­ed just after the birth

BACKGROUND

The preferred timing of umbilical-cord clamping in preterm infants is unclear.

 METHODS

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  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