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Effect of Umbilical Cord Milking vs Delayed Cord Clamping on Venous Hematocrit at 48 Hours in Late Preterm and Term Neonates: A Randomized Controlled Trial

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Abstract

Objective

To compare the effect of intact umbilical cord milking (MUC) and delayed cord clamping (DCC) on venous hematocrit at 48 (±6) hours in late preterm and term neonates (350/7–426/7 wk).

Study Design

Randomized trial.

Setting and participants

All late preterm and term neonates (350/7–426/7 wk) neonates born in the labor room and maternity operation theatre of tertiary care unit were included.

Intervention

We randomly allocated enrolled neonates to MUC group (cord milked four times towards the baby while being attached to the placenta; n=72) or DCC group (cord clamped after 60 seconds; n=72).

Outcome

Primary outcome was venous hematocrit at 48 (±6) hours of life. Additional outcomes were venous hematocrit at 48 (±6) hours in newborns delivered through lower segment caesarean section (LSCS), incidence of polycythemia requiring partial exchange transfusion, incidence of hyperbilirubinemia requiring phototherapy, and venous hematocrit and serum ferritin levels at 6 (±1) weeks of age.

Results

The mean (SD) hematocrit at 48 (±6) hours in the MUC group was higher than in DCC group [57.7 (4.3) vs. 55.9 (4.4); P=0.002]. Venous hematocrit at 6 (±1) weeks was higher in MUC than in DCC group [mean (SD), 37.7 (4.3) vs. 36 (3.4); mean difference 1.75 (95% CI 0.53 to 2.9); P=0.005]. Other parameters were similar in the two groups.

Conclusion

MUC leads to a higher venous hematocrit at 48 (±6) hours in late preterm and term neonates when compared with DCC.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India

    Mukul Kumar Mangla, Anu Thukral, M. Jeeva Sankar, Ramesh Agarwal, Ashok K. Deorari & V. K. Paul

Authors
  1. Mukul Kumar Mangla
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  2. Anu Thukral
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  3. M. Jeeva Sankar
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  4. Ramesh Agarwal
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  5. Ashok K. Deorari
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  6. V. K. Paul
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Corresponding author

Correspondence to Anu Thukral.

Additional information

Ethics clearance

Institute Ethics Committee, AIIMS; No. IECPG/197/24.02.2016, RT-10, dated March 30, 2016.

Contributors

MKM: protocol development, study implementation, data management and writing the manuscript; AT, MJS: development of the protocol and supervised implementation of the study and contributed to writing of the manuscript and did data analysis; VKP, AKD, RA: protocol development, and provided critical inputs in manuscript writing. All authors approved the final version of manuscript, and are accountable for all aspects related to the study.

Funding

None

Competing interests

None stated.

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Mangla, M.K., Thukral, A., Sankar, M.J. et al. Effect of Umbilical Cord Milking vs Delayed Cord Clamping on Venous Hematocrit at 48 Hours in Late Preterm and Term Neonates: A Randomized Controlled Trial. Indian Pediatr 57, 1119–1123 (2020). https://doi.org/10.1007/s13312-020-2064-7

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  • DOI: https://doi.org/10.1007/s13312-020-2064-7

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