Intraventricular Hemorrhage Clinical Trial
Official title:
Delayed Cord Clamping at 30 vs. 60 Seconds for Very Low Birth Weight Infants: A Randomized Controlled Trial
The purpose of this study is to determine if there is a difference in neonatal outcomes with delayed umbilical cord clamping at 30 versus 60 seconds. Our primary outcome will be intraventricular hemorrhage (IVH) (bleeding in the brain) in these infants.
Immediately following delivery, up to 40% of the total blood volume available to the infant
is in the placenta. Over a period of 30 seconds to 3 minutes, a significant portion of this
blood is transferred to the infant through the umbilical cord. Delayed cord clamping
following delivery facilitates this transfer of blood.
Preterm infants are very susceptible to the effects of anemia and hypovolemia. A recent
meta-analysis showed that a brief delay in umbilical cord clamping (30-60 seconds) decreases
the risk of anemia, blood transfusion, intraventricular hemorrhage, necrotizing
enterocolitis, and the need for blood pressure support after delivery. The same meta-analysis
showed no impact on Apgar scores or hypothermia due to a brief delay in resuscitation efforts
to allow delayed cord clamping.
Preterm infants are at significant risk for IVH and as high as 20% of very low birth weight
infants will have it. IVH is an important cause of brain injury in these infants. In our
study, we would like to determine the optimal timing of delayed cord clamping in order to
prevent IVH in these infants.
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