CSAR's latest publication: Association of Umbilical Cord Milking vs Delayed Umbilical Cord Clamp

Key Points

Question Is there a difference in the rates of death or severe intraventricular hemorrhage among preterm infants who receive placental transfusion with umbilical cord milking vs delayed umbilical cord clamping?

Findings In a randomized clinical trial that was terminated early, precluding the planned noninferiority analysis and requiring post hoc comparison, 474 of a planned 1500 infants born at less than 32 weeks’ gestation were enrolled. There was no significant difference in the composite primary outcome of death or severe intraventricular hemorrhage for the umbilical cord milking group vs the delayed umbilical cord clamping group (12% vs 8%, respectively), but umbilical cord milking was significantly associated with a higher rate of severe intraventricular hemorrhage (8% vs 3%).

Meaning Among preterm infants born at less than 32 weeks’ gestation, there was no significant difference in the rates of the composite primary outcome of death or severe intraventricular hemorrhage with umbilical cord milking vs delayed umbilical cord clamping, but a significantly higher rate of severe intraventricular hemorrhage (a signal of harm) in the umbilical cord milking group led to early termination of the study. The early study termination and post hoc nature of the analyses preclude definitive conclusions.