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Effect of delayed cord clamping on stem cell transfusion and hematological parameters in preterm infants with placental insufficiency: a pilot randomized trial.
Eur J Pediatr. 2020 Jul 04 [Online ahead of print]EJ

Abstract

The feasibility of delayed cord clamping (DCC) in preterm infants with placental insufficiency (PI) is questionable. We aimed to study the effect of DCC on stem cell transfusion, hematological parameters, and clinical outcomes in preterm infants born to mothers with PI. Preterm infants, < 34 weeks' gestation, born to mothers with PI were randomized based on the timing of umbilical cord clamping into delayed clamping for 60 s (DCC group) or immediate cord clamping (ICC group) groups at time of birth. CD34 percentage as a marker of stem cell transfusion, early and late-onset anemia, hypothermia, hypotension, polycythemia, hyperbilirubinemia, duration of oxygen therapy, bronchopulmonary dysplasia, intra-ventricular hemorrhage, necrotizing enterocolitis, sepsis, mortality, and length of hospital stay were compared between studied groups. We found that peripheral blood CD34 percentage was significantly higher in DCC compared with that in the ICC group (median (IQR) of 0.5 (0.40-0.7) versus 0.35 (0.20-0.5), p = 0.004). Infants in the DCC group had significantly lower episodes of anemia of prematurity at 2 months, red blood cell transfusion, and shorter duration of oxygen therapy compared with those in the ICC group.

Conclusion:

In conclusion, DCC compared with ICC increased stem cell transfusion and decreased early- and late-onset anemia in preterm infants with placental insufficiency.Trial registration: NCT03731546 www.clinicaltrials.gov What is Known: • Delayed cord clamping has been recommended by the American Academy of Pediatrics as a standard of care practice during delivery of preterm infants. • The feasibility of DCC in preterm infants with placental insufficiency (PI) is uncertain. What is New: • This randomized controlled trial demonstrated that DCC in the delivery room care of preterm infants born to mothers with placental insufficiency increased stem cell transfusion and decreased early- and late-onset anemia.

Authors+Show Affiliations

Neonatal Intensive Care Unit, Department of Pediatrics, Mansoura University Children's Hospital, Gomhoria Street, Mansoura, 35516, Egypt.Neonatal Intensive Care Unit, Department of Pediatrics, Mansoura University Children's Hospital, Gomhoria Street, Mansoura, 35516, Egypt. Department of Pediatrics, Faculty of Medicine, University of Mansoura, Mansoura, Egypt.Department of Obstetrics and Gynecology, Faculty of Medicine, University of Mansoura, Mansoura, Egypt.Department of Clinical Pathology, Faculty of Medicine, University of Mansoura, Mansoura, Egypt.Department of Pediatrics, Faculty of Medicine, University of Mansoura, Mansoura, Egypt. Hematology and Oncology Unit, Mansoura University Children's Hospital, Mansoura, Egypt.Neonatal Intensive Care Unit, Department of Pediatrics, Mansoura University Children's Hospital, Gomhoria Street, Mansoura, 35516, Egypt. Department of Pediatrics, Faculty of Medicine, University of Mansoura, Mansoura, Egypt.Neonatal Intensive Care Unit, Department of Pediatrics, Mansoura University Children's Hospital, Gomhoria Street, Mansoura, 35516, Egypt. nehad_nasef@mans.edu.eg. Department of Pediatrics, Faculty of Medicine, University of Mansoura, Mansoura, Egypt. nehad_nasef@mans.edu.eg.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32623628

Citation

Yunis, Mohammed, et al. "Effect of Delayed Cord Clamping On Stem Cell Transfusion and Hematological Parameters in Preterm Infants With Placental Insufficiency: a Pilot Randomized Trial." European Journal of Pediatrics, 2020.
Yunis M, Nour I, Gibreel A, et al. Effect of delayed cord clamping on stem cell transfusion and hematological parameters in preterm infants with placental insufficiency: a pilot randomized trial. Eur J Pediatr. 2020.
Yunis, M., Nour, I., Gibreel, A., Darwish, M., Sarhan, M., Shouman, B., & Nasef, N. (2020). Effect of delayed cord clamping on stem cell transfusion and hematological parameters in preterm infants with placental insufficiency: a pilot randomized trial. European Journal of Pediatrics. https://doi.org/10.1007/s00431-020-03730-4
Yunis M, et al. Effect of Delayed Cord Clamping On Stem Cell Transfusion and Hematological Parameters in Preterm Infants With Placental Insufficiency: a Pilot Randomized Trial. Eur J Pediatr. 2020 Jul 4; PubMed PMID: 32623628.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of delayed cord clamping on stem cell transfusion and hematological parameters in preterm infants with placental insufficiency: a pilot randomized trial. AU - Yunis,Mohammed, AU - Nour,Islam, AU - Gibreel,Ahmed, AU - Darwish,Mohamad, AU - Sarhan,Mohamed, AU - Shouman,Basma, AU - Nasef,Nehad, Y1 - 2020/07/04/ PY - 2020/04/28/received PY - 2020/07/01/accepted PY - 2020/06/27/revised PY - 2020/7/6/entrez PY - 2020/7/6/pubmed PY - 2020/7/6/medline KW - Anemia neonatorum KW - Placental insufficiency KW - Preterm infant KW - Stem cell KW - Umbilical cord JF - European journal of pediatrics JO - Eur. J. Pediatr. N2 - The feasibility of delayed cord clamping (DCC) in preterm infants with placental insufficiency (PI) is questionable. We aimed to study the effect of DCC on stem cell transfusion, hematological parameters, and clinical outcomes in preterm infants born to mothers with PI. Preterm infants, < 34 weeks' gestation, born to mothers with PI were randomized based on the timing of umbilical cord clamping into delayed clamping for 60 s (DCC group) or immediate cord clamping (ICC group) groups at time of birth. CD34 percentage as a marker of stem cell transfusion, early and late-onset anemia, hypothermia, hypotension, polycythemia, hyperbilirubinemia, duration of oxygen therapy, bronchopulmonary dysplasia, intra-ventricular hemorrhage, necrotizing enterocolitis, sepsis, mortality, and length of hospital stay were compared between studied groups. We found that peripheral blood CD34 percentage was significantly higher in DCC compared with that in the ICC group (median (IQR) of 0.5 (0.40-0.7) versus 0.35 (0.20-0.5), p = 0.004). Infants in the DCC group had significantly lower episodes of anemia of prematurity at 2 months, red blood cell transfusion, and shorter duration of oxygen therapy compared with those in the ICC group.Conclusion: In conclusion, DCC compared with ICC increased stem cell transfusion and decreased early- and late-onset anemia in preterm infants with placental insufficiency.Trial registration: NCT03731546 www.clinicaltrials.gov What is Known: • Delayed cord clamping has been recommended by the American Academy of Pediatrics as a standard of care practice during delivery of preterm infants. • The feasibility of DCC in preterm infants with placental insufficiency (PI) is uncertain. What is New: • This randomized controlled trial demonstrated that DCC in the delivery room care of preterm infants born to mothers with placental insufficiency increased stem cell transfusion and decreased early- and late-onset anemia. SN - 1432-1076 UR - https://www.unboundmedicine.com/medline/citation/32623628/Effect_of_delayed_cord_clamping_on_stem_cell_transfusion_and_hematological_parameters_in_preterm_infants_with_placental_insufficiency:_a_pilot_randomized_trial L2 - https://dx.doi.org/10.1007/s00431-020-03730-4 DB - PRIME DP - Unbound Medicine ER -
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