School age outcomes of very premature infants randomized to cord milking versus early cord clamping at birth


Akyol Ozkara K., Alan S., ÖZALP AKIN E., OKULU E., BİNGÖLER PEKCİCİ E. B., ERDEVE Ö., ...Daha Fazla

European Journal of Pediatrics, cilt.184, sa.7, 2025 (SCI-Expanded, Scopus) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 184 Sayı: 7
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1007/s00431-025-06299-y
  • Dergi Adı: European Journal of Pediatrics
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE
  • Anahtar Kelimeler: Long term outcome, Placental transfusion, Umbilical cord milking, Very preterm newborn, Vineland adaptive behaviour scales, Wechsler intelligence scale for children
  • Ankara Üniversitesi Adresli: Evet

Özet

To evaluate the effect of intact cord milking (I-UCM) compared to immediate cord clamping (ICC) on neurodevelopmental outcomes at seven years of age in very preterm infants. This prospective single-blind cohort study included children who were previously participated in a randomized controlled trial comparing I-UCM and ICC. At about 7 years of age, participants were administered the Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) and the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). A total of 31 children were included in the follow-up study. The mean age of participants was 6.4 ± 0.5 years. The mean gestational age at birth was 28.5 ± 1.7 weeks. There were no cases with grade ≥ 3 intraventriculary hemorrhage (IVH) in the present study cohort. Although the I-UCM group showed a trend toward higher median full-scale IQ, the difference was not statistically significant (p: 0.057). A significantly higher percentage of cases in the I-UCM group achived a full-scale IQ above 85 in the WISC-IV (p = 0.048). The mean of the "written language scaled score" subdomain among Vineland-II scores was found to be significantly higher in the I-UCM group. A significantly higher percentage of cases in the I-UCM group had a written language scaled score above 12 (p: 0.029). Conclusion: A comparison of I-UCM with ICC in preterm infants born at a mean age of 28 weeks and without severe IVH revealed that I-UCM did not result in long-term neurodevelopmental adverse outcomes. I-UCM even had positive effects in some subdomains of detailed neurodevelopmental tests. (Table presented.)