Resuscitation with Intact Cord Versus Clamped Cord in Late Preterm and Term Neonates: A Randomized Controlled Trial - 14/03/23
, Suksham Jain, DM 1, Supreet Khurana, DM 1, Alka Sehgal, MD 2, Shikha Rani, MD 2Abstract |
Objective |
To compare the effect of intact cord versus clamped cord resuscitation on the physiologic transition of neonates receiving positive-pressure ventilation (PPV) at birth.
Study design |
This open-label, parallel-group, randomized controlled superiority trial was conducted in a tertiary care hospital in India. Neonates born at ≥34 weeks of gestation after a complicated pregnancy or labor were randomized just before birth to receive resuscitation according to the Neonatal Resuscitation Program algorithm with either an intact cord (intact cord resuscitation group) or after early cord clamping (early cord clamping resuscitation group). The allocated study intervention was administered if the neonate needed PPV at birth. The primary outcome was expanded Apgar score at 5 minutes after birth.
Results |
Birth weight, gestational age, and the incidence of pregnancy complications were similar in the 2 study groups. The proportion of neonates who received PPV was lower in the intact cord resuscitation group (28.7% vs 36.5%, P = .05; relative risk, 0.79; 95% CI, 0.61-1.01). Among neonates who received PPV, the expanded Apgar score at 5 minutes was significantly higher in the intact cord resuscitation group (median, 15 [IQR, 14-15] vs 14 [IQR, 13-15]; P < .001). The expanded Apgar score at 10 minutes, Apgar scores at 5 and 10 minutes, and oxygen saturation at 1, 5, and 10 minutes were also higher in the intact cord resuscitation group.
Conclusion |
In late preterm and term neonates, resuscitation with an intact cord results in better postnatal physiologic transition than the standard practice of resuscitation after immediate cord clamping.
Trial registration |
Clinical Trial Registry of India (www.ctri.nic.in); trial registration no. CTRI/2020/02/023379.
Le texte complet de cet article est disponible en PDF.Keywords : birth asphyxia, placental transfusion
Abbreviations : DCC, HIE, NICU, NRP, PPV, RCT
Plan
| The authors declare no conflicts of interest. |
Vol 254
P. 54 - mars 2023 Retour au numéro
Article précédent
- Effectiveness of BNT162b2 Vaccination During Pregnancy in Preventing Hospitalization for Severe Acute Respiratory Syndrome Coronavirus 2 in Infants
- Dana Danino, Liat Ashkenazi-Hoffnung, Alejandro Diaz, Amir Dov Erps, Noa Eliakim-Raz, Yonat Shemer Avni, David Greenberg, Noga Givon-Lavi, Ilan Youngster
- Acid Suppression and Antibiotics Administered during Infancy Are Associated with Celiac Disease
- Michael Boechler, Apryl Susi, Elizabeth Hisle-Gorman, Philip L. Rogers, Cade M. Nylund
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?