Timing of umbilical cord occlusion, delayed vs early, in preterm babies: A randomized controlled trial (CODE-P Trial).

INTRODUCTION: Our hypothesis was that delayed cord clamping (DCC) (not earlier than 30 s; at 30-60 s) in premature neonates (born between 26.0 and 32.6 weeks of gestation), as compared with the usual early cord clamping (ECC), significantly reduces the need for blood transfusions and incidence of intraventricular haemorrhage (IVH) without an increased rate of maternal postpartum haemorrhage. MATERIAL AND METHODS: A prospective, open-label, randomized, controlled trial was conducted at Vall d'Hebron Hospital from July 2014 to December 2018. All pregnant women at risk of impending preterm birth (≥26.0-<33.0 weeks of gestation) who were admitted to the obstetrics emergency department were evaluated for eligibility. If they met the eligibility criteria, they were invited to participate in the study and, if they agreed, they signed an informed consent. Patients were randomly assigned to one of two groups: ECC group and DCC group. RESULTS: Our study included a total of 57 patients: 30 in the ECC group and 27 in the DCC group. Due to a lack of funding and low recruitment rates, the study was discontinued in 2018. Maternal characteristics and obstetric outcomes were similar between both groups. The intention-to-treat analysis did not reveal any differences between groups for neonatal red blood cell transfusions, neonatal IVH or maternal postpartum haemorrhage. There were no differences for secondary outcomes. Similarly, no differences were observed in the as-treated analysis. CONCLUSION: The primary and secondary outcomes of our study were not achieved. Therefore, more meta-analysis and trials are needed to evaluate the appropriate timing of cord clamping in preterm birth.

Women taking a lead in health promotion.

PIP: Samahang Batanguena (Women's Group) of Balayan works together with the municipal government as the only women's organization in the province of Batangas accredited by the local government. A member of the municipality's health board, Samahang Batanguena is also affiliated with the National Council for Women. Most of the organization's activities are concerned with promoting the health of the community's people, with Samahang Batanguena organizing a range of activities throughout the year. The group's women take such effort to keep their neighborhoods clean that Samahang Batanguena won the national clean and green project's top prize in 1995, and used the prize money of 55,000 pesos for project development. Since 1993, Samahang Batanguena has been working in concert with the community-based family planning and reproductive health project, in the interest of helping women. Many men are either actively participating in Samahang Batanguena's activities or supporting their wives' involvement.^ieng