J Korean Soc Neonatol.  2012 Nov;19(4):204-211. 10.5385/jksn.2012.19.4.204.

Effect of Umbilical Cord Milking in Extremely Low Birth Weight Infants

Affiliations
  • 1Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
  • 2Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wonspark@skku.edu
  • 3Department of Pediatrics, Chonbuk National University College of Medicine, Jeonju, Korea.
  • 4Department of Pediatrics, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
  • 5Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

PURPOSE
To investigate the effects of umbilical cord milking on the level of the hemoglobin, frequency of transfusion, initial adaptation after birth and morbidities in the extremely low birth weight infants (ELBWI).
METHODS
Medical records of ELBWI admitted to the Samsung Medical Center Neonatal Intensive Care Unit from November 2007 to October 2010 were reviewed retrospectively. Before June 2009, infants' umbilical cords were clamped immediately (control group, n=39). After that time, umbilical cords were clamped after repeated (two or three times) milking of the cord toward the neonate under the radiant warmer (milking group, n=37).
RESULTS
ELBWI with a gestational age of > or =26 weeks presented higher level of hemoglobin at the age of 3 days (16.9+/-2.6 vs. 14.3+/-2.3 g/dL, P=0.008) and 7 days (14.6+/-1.7 vs. 12.6+/-1.8 g/dL, P=0.005), lower frequency of transfusion during the hospital days (2.5+/-0.7 vs. 4.0+/-3.0) and smaller number of neonate undergoing transfusion within the first three weeks of life in the milking group than the control group (30% vs. 70%). There was no significant difference between the two groups in blood pressure and the urine output changes. There was no significant difference in mortality and morbidity, including respiratory distress syndrome, patent ductus arteriosus, bronchopulmonary dysplasia and intraventricular hemorrhage.
CONCLUSION
Umbilical cord milking in ELBWI may be a useful method to reduce transfusion in neonates, especially in those of longer than 26 weeks gestation.

Keyword

Umbilical cord milking; Transfusion; Extremely low birth weight infant

MeSH Terms

Blood Pressure
Bronchopulmonary Dysplasia
Ductus Arteriosus, Patent
Gestational Age
Hemoglobins
Humans
Infant
Infant, Extremely Low Birth Weight
Infant, Low Birth Weight
Infant, Newborn
Intensive Care, Neonatal
Medical Records
Milk
Parturition
Pregnancy
Retrospective Studies
Umbilical Cord
Hemoglobins
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