Effects of Placental Transfusion by Delayed Cord Clamping or Umbilical Cord Milking Versus Immediate Cord Clamping on Neonatal Outcomes in Very Low Birth Weight Neonates: A Recent Study

Background: Delayed cord clamping (DCC) and umbilical cord milking (UCM) are two recently advocated interventions to enhance placental trans-fusion at birth. DCC and UCM might increase blood volume and help neo-nates to transition from fetal to neonatal circulation. Objective: To evaluate the effects of delayed cord clamping (DCC), umbilical cord milking (UCM), and immediate cord clamping (ICC) on very low birth weight (VLBW) neo-nates. Methods: At our institution, ICC was routinely done until December, 2012 when it was replaced by DCC. UCM was implemented in March, 2015. Neonatal outcomes were compared among ICC, DCC, and UCM. Results: A total of 94 neonates met inclusion criteria. Comparing with ICC neonates, DCC and UCM neonates had higher hematocrits, fewer blood transfusions, and lower incidence of chronic lung disease at 36 completed weeks of gestation. All groups were similar in APGAR scores, vasopressor use, intraventricular hemorrhage (IVH) and necrotizing enterocolitis (NEC). Conclusion: Compared to ICC, DCC and UCM appear to be more beneficial to VLBW neonates without apparent adverse risks. The use of either method to enhance placental transfusion appears to be superior to ICC and may be considered as an option in the delivery of VLBW neonates to optimize outcomes.