Exposure to umbilical cord management approaches and death or neurodevelopmental impairment at 22-26 months' corrected age after extremely preterm birth
التفاصيل البيبلوغرافية
العنوان:
Exposure to umbilical cord management approaches and death or neurodevelopmental impairment at 22-26 months' corrected age after extremely preterm birth
ObjectiveTo compare death or severe neurodevelopmental impairment (NDI) at 22–26 months’ corrected age (CA) among extremely preterm infants following exposure to different forms of umbilical cord management.DesignRetrospective study.SettingEunice Kennedy ShriverNational Institute of Child Health and Human Development Neonatal Research Network registry.PatientsInfants born ExposuresImmediate cord clamping (ICC), delayed cord clamping (DCC) or umbilical cord milking (UCM).Main outcomes and measurePrimary composite outcome of death or severe NDI at 22–26 months’ CA, defined as severe cerebral palsy, Bayley-III cognitive/motor composite score ResultsAmong 1900 infants, 64.1% were exposed to ICC, 27.8% to DCC and 8.1% to UCM. Compared with ICC-exposed infants, DCC-exposed infants had lower odds of death or severe NDI (adjusted OR 0.64, 95% CI 0.50 to 0.83). No statistically significant differences were observed when comparing UCM with either ICC or DCC, or between secondary outcomes across groups. Association between cord management and the primary outcome was not mediated by severe IVH.ConclusionCompared with ICC, DCC exposure was associated with lower death or severe NDI at 22–26 months’ CA among extremely preterm infants, which was not mediated by severe IVH.
