Several umbilical cord management strategies exist, but which one is the best for preventing mortality and morbidities in preterm infants is not clear. The objective of this study is to systematically review and conduct a meta-analysis of four umbilical cord management strategies: delayed umbilical cord clamping (DCC), immediate umbilical cord clamping (ICC), umbilical cord milking (UCM), and UCM and DCC.
This systematic review and meta-analysis included 46 randomized clinical trials comparing different umbilical cord management strategies for preterm infants. A total of 6,852 infants were included in the analysis. The primary outcome of the study was predischarge mortality, along with intraventricular hemorrhage, need for red blood cell transfusion, and neonatal morbidities.
When compared with ICC, DCC was found to be associated with lower odds of mortality, intraventricular hemorrhage, and the need for packed red blood cell transfusion. Similarly, when compared with ICC, UCM was associated with lower odds of intraventricular hemorrhage and feed for red blood cell transfusion, but no differences in secondary outcomes. Besides, there was no significant difference in primary and secondary outcomes for UCM vs. DCC.
The research concluded that when compared with ICC, DCC was associated with a lower risk of mortality in preterm infants, whereas DCM and UCM were associated with reductions in intraventricular hemorrhage and packed red cell transfusion.
Ref: https://jamanetwork.com/journals/jamapediatrics/article-abstract/2776977?resultClick=1
