[Influence of umbilical cord milking versus delayed cord clamping on the early prognosis of preterm infants with a gestational age of <34 weeks: a Meta analysis].

Abstract

OBJECTIVES:

To study the influence of umbilical cord milking versus delayed cord clamping on the early prognosis of preterm infants with a gestational age of <34 weeks.

METHODS:

PubMed, Web of Science, Embase, the Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wanfang Data, Weipu Database, and SinoMed were searched for randomized controlled trials on umbilical cord milking versus delayed cord clamping in preterm infants with a gestational age of <34 weeks published up to November 2021. According to the inclusion and exclusion criteria, two researchers independently performed literature screening, quality evaluation, and data extraction. Review Manger 5.4 was used for Meta analysis.

RESULTS:

A total of 11 articles were included in the analysis, with 1 621 preterm infants in total, among whom there were 809 infants in the umbilical cord milking group and 812 in the delayed cord clamping group. The Meta analysis showed that compared with delayed cord clamping, umbilical cord milking increased the mean blood pressure after birth (weighted mean difference=3.61, 95%CI: 0.73-6.50, P=0.01), but it also increased the incidence rate of severe intraventricular hemorrhage (RR=1.83, 95%CI: 1.08-3.09, P=0.02). There were no significant differences between the two groups in hemoglobin, hematocrit, blood transfusion rate, proportion of infants undergoing phototherapy, bilirubin peak, and incidence rates of complications such as periventricular leukomalacia and necrotizing enterocolitis (P>0.05).

CONCLUSIONS:

Compared with delayed cord clamping, umbilical cord milking may increase the risk of severe intraventricular hemorrhage in preterm infants with a gestational age of <34 weeks; however, more high-quality large-sample randomized controlled trials are needed for further confirmation.

• Authors: Wei-Wei Jiang, Xue-Mei Fan, Jia-Hua Zhang, Zi-Man Fu, Cong-Shan Pu, Chun-Jian Shan
• Journal: Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics (Zhongguo Dang Dai Er Ke Za Zhi) Vol. 24 Issue 5 Pg. 492-499 (May 15 2022) ISSN: 1008-8830 [Print] China
• Vernacular Title: 脐带挤压与延迟断脐对胎龄<34周早产儿早期预后影响的Meta分析.
• PMID: 35644188 (Publication Type: Journal Article, Meta-Analysis)

Topics

• Cerebral Hemorrhage
• Constriction
• Female
• Gestational Age
• Humans
• Infant
• Infant, Newborn
• Infant, Premature
• Pregnancy
• Prognosis
• Umbilical Cord (physiology)
• Umbilical Cord Clamping