Randomised trial of cord clamping at very preterm birth: outcomes at 2 years.
Arch Dis Child Fetal Neonatal Ed
; 105(3): 292-298, 2020 May.
Article
en En
| MEDLINE
| ID: mdl-31371434
ABSTRACT
OBJECTIVE:
To report outcomes at 2 years corrected age for children of women recruited to a trial comparing alternative policies for timing of cord clamping and immediate neonatal care at very preterm birth.DESIGN:
Parallel group randomised (11) trial.SETTING:
Eight UK tertiary maternity units.PARTICIPANTS:
Two hundred and seventy-six babies born to 261 women expected to have a live birth before 32+0 weeks' gestation.INTERVENTIONS:
Deferred cord clamping (≥2 min) and immediate neonatal care with cord intact or immediate (≤20 s) clamping and immediate neonatal care after clamping. MAIN OUTCOMEMEASURE:
Composite of death or adverse neurodevelopmental outcome at 2 years corrected age.RESULTS:
Six babies born after 35+6 weeks were excluded. At 2 years corrected age, outcome data were not available for a further 52 children, leaving 218 for analysis (115 deferred clamping, 103 immediate clamping). Overall, 24/115 (21%) children allocated deferred clamping died or had an adverse neurodevelopmental outcome compared with 35/103 (34%) allocated immediate clamping; risk ratio (RR) 0.61 (95% CI 0.39 to 0.96); risk difference (RD) -13% (95% CI -25% to -1%). Multiple imputation for missing data gave an RR 0.69 (95% CI 0.44 to 1.09) and RD -9% (95% CI -21% to 2%).CONCLUSIONS:
Deferred clamping and immediate neonatal care with cord intact may reduce the risk of death or adverse neurodevelopmental outcome at 2 years of age for children born very premature. Confirmation in larger studies is needed to determine the real benefits and harms. TRIAL REGISTRATION NUMBER ISRCTN21456601.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
7_ODS3_muertes_prevenibles_nacidos_ninos
Problema de salud:
2_muertes_prevenibles
/
7_neonatal_care_health
/
7_nutrition
Asunto principal:
Cordón Umbilical
/
Desarrollo Infantil
/
Nacimiento Prematuro
/
Recien Nacido Extremadamente Prematuro
Tipo de estudio:
Clinical_trials
Límite:
Adult
/
Child, preschool
/
Female
/
Humans
/
Newborn
País/Región como asunto:
Europa
Idioma:
En
Revista:
Arch Dis Child Fetal Neonatal Ed
Asunto de la revista:
PEDIATRIA
/
PERINATOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Reino Unido