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

Background: Delayed cord clamping (DCC) and umbilical cord milking (UCM) are two recently advocated interventions to enhance placental transfusion at birth. DCC and MCM might increase blood volume and help neonates 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) neonates. 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.