Delayed versus Immediate Cord Clamping in Preterm Infants

Tarnow‐Mordi, William; Morris, Jonathan M.; Kirby, Adrienne; Robledo, Kristy; Askie, Lisa; Brown, Rebecca T.; Evans, Nicholas J.; Finlayson, Sarah; Fogarty, Michael J.; Gebski, Val; Ghadge, Alpana; Hague, Wendy; Isaacs, David; Jeffery, Michelle; Keech, Anthony; Kluckow, Martin; Popat, Himanshu; Sebastian, Lucille; Aagaard, Kjersti M.; Belfort, Michael A.; Pammi, Mohan; Abdel-Latif, Mohamed E; Reynolds, Graham; Ariff, Shabina; Sheikh, Lumaan; Chen, Yan; Colditz, Paul B.; Liley, Helen; Pritchard, Margo; Luca, Danièle De; Waal, Koert de; Forder, Peta; Duley, Lelia; El-Naggar, Walid; Gill, Andrew; Newnham, John P.; Simmer, Karen; Groom, Katie; Weston, Philip J.; Gullam, Joanna; Patel, Harshad; Koh, Guan; Lui, Kei; Marlow, Neil; Morris, Scott; Sehgal, Arvind; Wallace, Euan M.; Soll, Roger F.; Young, Leslie; Sweet, David G.; Walker, Susan; Watkins, Andrew; Wright, Ian; Osborn, David A; Simes, John

doi:10.1056/nejmoa1711281

Cited by 227 publications

(122 citation statements)

References 33 publications

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“…Delayed “physiological” clamping after lung aeration results in much smoother transition and less bradycardia in animal models [36]. The Australian Placental Transfusion Study randomised 1,600 babies less than 30 weeks’ gestation to immediate (within 10 s) or delayed clamping (after 60 s or more) [37]. However, even such a large study was insufficiently powered to determine a difference in the primary outcome of death or major morbidity.…”

Section: Delivery Room Stabilisationmentioning

confidence: 99%

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

et al. 2019

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As management of respiratory distress syndrome (RDS) advances, clinicians must continually revise their current practice. We report the fourth update of “European Guidelines for the Management of RDS” by a European panel of experienced neonatologists and an expert perinatal obstetrician based on available literature up to the end of 2018. Optimising outcome for babies with RDS includes prediction of risk of preterm delivery, need for appropriate maternal transfer to a perinatal centre and timely use of antenatal steroids. Delivery room management has become more evidence-based, and protocols for lung protection including initiation of CPAP and titration of oxygen should be implemented immediately after birth. Surfactant replacement therapy is a crucial part of management of RDS, and newer protocols for its use recommend early administration and avoidance of mechanical ventilation. Methods of maintaining babies on non-invasive respiratory support have been further developed and may cause less distress and reduce chronic lung disease. As technology for delivering mechanical ventilation improves, the risk of causing lung injury should decrease, although minimising time spent on mechanical ventilation using caffeine and, if necessary, postnatal steroids are also important considerations. Protocols for optimising general care of infants with RDS are also essential with good temperature control, careful fluid and nutritional management, maintenance of perfusion and judicious use of antibiotics all being important determinants of best outcome.

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Section: Delivery Room Stabilisationmentioning

confidence: 99%

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

et al. 2019

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“…Few studies on DCC enrolled multiple pregnancies [2-5]. The largest available trial [5] randomized 390 newborns from multiple pregnancies (25% of a cohort of 1,566 infants with gestational age lower than 30 weeks) to ECC or 60-s DCC.…”

mentioning

confidence: 99%

“…The largest available trial [5] randomized 390 newborns from multiple pregnancies (25% of a cohort of 1,566 infants with gestational age lower than 30 weeks) to ECC or 60-s DCC. They concluded for a significant higher hematocrit in the first week of life for both vaginally delivered (VD) and CD newborns randomized to DCC, compared to ECC, without side effects.…”

mentioning

confidence: 99%

Delayed Cord Clamping in Twin Pregnancies: To Do or Not to Do?

Ghirardello

Mosca

2019

Neonatology

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“…However, since our study is the first one on this patient population and not without limitations, further studies are needed to confirm our findings. We feel that it would be very helpful, if the existing studies on DCC that enrolled singletons and twins, such as a recent large-scale randomized controlled trial of DCC by Tarnow-Mordi et al [3], could perform subgroup analyses and report on the outcomes of twins. Such results would be very interesting as well, since they would provide more evidence on how umbilical cord clamping should be managed in these patients.…”

mentioning

confidence: 99%