RT Journal Article
SR Electronic
T1 Placental transfusion and short-term outcomes among extremely preterm infants
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 62
OP 68
DO 10.1136/archdischild-2019-318710
VO 106
IS 1
A1 Kumbhat, Neha
A1 Eggleston, Barry
A1 Davis, Alexis S
A1 Van Meurs, Krisa P
A1 DeMauro, Sara Bonamo
A1 Foglia, Elizabeth E
A1 Lakshminrusimha, Satyanarayan
A1 Walsh, Michele C
A1 Watterberg, Kristi L
A1 Wyckoff, Myra H
A1 Das, Abhik
A1 Handley, Sara C
A1 
YR 2021
UL http://fn.bmj.com/content/106/1/62.abstract
AB Objective To compare short-term outcomes after placental transfusion (delayed cord clamping (DCC) or umbilical cord milking (UCM)) versus immediate cord clamping among extremely preterm infants.Design Retrospective study.Setting The Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network registry.Patients Infants born <29 weeks’ gestation in 2016 or 2017 without congenital anomalies who received active treatment after delivery.Intervention/exposure DCC or UCM.Main outcome measures Primary outcomes: (1) composite of mortality or major morbidity by 36 weeks’ postmenstrual age (PMA); (2) mortality by 36 weeks PMA and (3) composite of major morbidities by 36 weeks’ PMA. Secondary composite outcomes: (1) any grade intraventricular haemorrhage or mortality by 36 weeks’ PMA and (2) hypotension treatment in the first 24 postnatal hours or mortality in the first 12 postnatal hours. Outcomes were assessed using multivariable regression, adjusting for mortality risk factors identified a priori, significant confounders and centre as a random effect.Results Among 3116 infants, 40% were exposed to placental transfusion, which was not associated with the primary composite outcome of mortality or major morbidity by 36 weeks’ PMA (adjusted OR (aOR) 1.26, 95% CI 0.95 to 1.66). However, exposure was associated with decreased mortality by 36 weeks’ PMA (aOR 0.71, 95% CI 0.55 to 0.92) and decreased hypotension treatment in first 24 postnatal hours (aOR 0.66, 95% CI 0.53 to 0.82).Conclusion In this extremely preterm infant cohort, exposure to placental transfusion was not associated with the composite outcome of mortality or major morbidity, though there was a reduction in mortality by 36 weeks’ PMA.Trial registration number NCT00063063.