Obstet Gynecol Sci.  2017 Nov;60(6):527-534. 10.5468/ogs.2017.60.6.527.

Safety of umbilical cord milking in very preterm neonates: a randomized controlled study

• Song SY
• Kim Y
• Kang BH
• Yoo HJ
• Lee M

• KMID: 2418353
• DOI: http://doi.org/10.5468/ogs.2017.60.6.527

Abstract

OBJECTIVE
To investigate the safety of umbilical cord milking on both the mother and neonate among very preterm deliveries of less than 33 weeks of gestation.
METHODS
Pregnant women who were expected to deliver at between 24 0/7 and 32 6/7 weeks of gestation were randomized to either the umbilical cord milking or immediate cord clamping group. Maternal and neonatal data associated with delivery, in addition to neonatal morbidity and mortality data, were collected and analyzed.
RESULTS
Of the 66 preterm deliveries included in the study, 34 were randomized into the milking and 32 into the clamping group. Differences between maternal pre- and post-partum hemoglobin levels were 1.35 g/dL in the milking and 1.58 g/dL in the clamping group (P=0.451). Neonatal Apgar scores at both 1 and 5 minutes, initial blood gas analysis results, body temperature at admission, need for early intubation, and maximum bilirubin levels were all similar between the 2 groups. However, neonatal hemoglobin levels at birth (15.79 vs. 14.69 g/dL; P<0.05) and at 24 hours of age (14.83 vs. 13.29 g/dL; P<0.05) were significantly higher in the milking group. Neonates in the clamping group required more blood transfusion (1.78 vs. 0.93; P=0.049), and a higher percentage of neonates in the clamping group required inotropic drugs (63% vs. 29%; P=0.007). The mortality rate was significantly lower in the milking group (6% vs. 28%; P=0.015).
CONCLUSION
Umbilical cord milking can be a safe and beneficial procedure for both the mother and the neonate in deliveries of less than 33 weeks of gestation.

Keyword

Fetomaternal transfusion; Anemia, neonatal; Infant, premature

MeSH Terms

Anemia, Neonatal
Bilirubin
Blood Gas Analysis
Blood Transfusion
Body Temperature
Constriction
Female
Fetomaternal Transfusion
Humans
Infant, Newborn*
Infant, Premature
Intubation
Milk*
Mortality
Mothers
Parturition
Pregnancy
Pregnant Women
Umbilical Cord*
Bilirubin

Figure

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  Fig. 1 Survival of preterm infants in milking and clamping group.

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