Evidence · Randomised trial
Ventilatory Assistance Before Umbilical Cord Clamping in Extremely Preterm Infants: A Randomized Clinical Trial.
- Cord management
- CPAP and high flow
- Delivery room and stabilisation
- Intraventricular haemorrhage and white matter injury
- Medical
- Neurology
- Newborn life support
- Nursing
- Preterm stabilisation
Summary
This phase 3 multicentre randomised trial across 12 US and Canadian perinatal centres compared 120 seconds of assisted ventilation (CPAP or positive-pressure ventilation) before cord clamping with 30 to 60 seconds of delayed cord clamping followed by standard resuscitation in infants born at 23 to 28 weeks' gestation. The primary outcome was any grade intraventricular haemorrhage or death before day 7, with prespecified analyses for infants breathing well and not breathing well at 30 seconds. Among 570 infants, there was no significant difference in IVH or early death, nor in death, severe brain injury or major morbidities, between groups. The authors conclude that further study of the feasibility, safety and efficacy of ventilation before cord clamping is needed.
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- Open (Creative Commons)
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