Delayed Umbilical Cord Clamping is Not Associated with Acute Kidney Injury in Very Low Birth Weight Neonates

Abstract

Objective This study aimed to determine if delayed cord clamping (DCC) is associated with a reduction in neonatal acute kidney injury (AKI). Study Design A retrospective single-center cohort study of 278 very low birth weight (VLBW) neonates was performed to compare the incidence of AKI in the following groups: immediate cord clamping (ICC), DCC, and umbilical cord milking. AKI was diagnosed by the modified neonatal Kidney Diseases and Improving Global Outcomes (KDIGO) definition. Results The incidence of AKI in the first week was 20.1% with no difference between groups (p = 0.78). After adjustment for potential confounders, the odds of developing AKI, following DCC, compared with ICC was 0.93 (confidence interval [CI]: 0.46–1.86) with no reduction in the stage of AKI between groups. Conclusion In this study, DCC was not associated with a reduced rate of AKI in VLBW neonates. However, the data suggest that DCC is also not harmful to the kidneys, further supporting the safety of DCC in VLBW neonates.

Association of delayed cord clamping with acute kidney injury and two-year kidney outcomes in extremely premature neonates: a secondary analysis of the Preterm Erythropoietin Neuroprotection Trial (PENUT)

“…Our ndings are consistent with previously published data. [20] There are a few potential explanations for our ndings. First, in a separate evaluation of this same cohort, it was found that correcting sCr for uid balance uncovered numerous missed episodes of AKI in the cohort.…”

“…[19] A retrospective single-center cohort study of 278 very low birth weight neonates found no differences in acute kidney injury (AKI) by cord management strategy and no studies have compared two year kidney outcomes by cord management strategy. [20] Our objective was to evaluate the association of different cord management strategies with AKI and twoyear kidney outcomes in ELGANs. We hypothesized that in ELGANs, DCC would be associated with decreased in-hospital AKI and improved two-year kidney outcomes compared to ECC.…”