To evaluate the effect of intact cord milking (I-UCM) compared to immediate cord clamping (ICC) on neurodevelopmental outcomes at seven years of age in very preterm infants. This prospective single-blind cohort study included children who were previously participated in a randomized controlled trial comparing I-UCM and ICC. At about 7 years of age, participants were administered the Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) and the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). A total of 31 children were included in the follow-up study. The mean age of participants was 6.4 ± 0.5 years. The mean gestational age at birth was 28.5 ± 1.7 weeks. There were no cases with grade ≥ 3 intraventriculary hemorrhage (IVH) in the present study cohort. Although the I-UCM group showed a trend toward higher median full-scale IQ, the difference was not statistically significant (p: 0.057). A significantly higher percentage of cases in the I-UCM group achived a full-scale IQ above 85 in the WISC-IV (p = 0.048). The mean of the "written language scaled score" subdomain among Vineland-II scores was found to be significantly higher in the I-UCM group. A significantly higher percentage of cases in the I-UCM group had a written language scaled score above 12 (p: 0.029).Conclusion: A comparison of I-UCM with ICC in preterm infants born at a mean age of 28 weeks and without severe IVH revealed that I-UCM did not result in long-term neurodevelopmental adverse outcomes. I-UCM even had positive effects in some subdomains of detailed neurodevelopmental tests.<Table Float="No" ID="Taba"> <tgroup cols="1"> <colspec align="left" colname="c1" colnum="1" /> <tbody> <row> <entry align="left" colname="c1"> What is Known: • Compared to immediate cord clamping, umbilical cord milking improves the short-term postnatal outcomes of very preterm infants. There is a lack of robust data regarding the long-term neurodevelopmental effects of umbilical cord milking in preterm infants. </entry> </row> <row> <entry align="left" colname="c1"> What is New: • Among very preterm infants without severe intraventricular hemorrhage, intact umbilical cord milking was not associated with long-term adverse neurodevelopmental outcomes. Intact-umbilical cord milking even had positive effects in some subdomains of detailed neurodevelopmental tests. </entry> </row> </tbody> </tgroup> </Table>

School age outcomes of very premature infants randomized to cord milking versus early cord clamping at birth

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2025年7月1日

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Kamile Akyol Ozkara,
Serdar Alan,
Ezgi Ozalp Akin,
Emel Okulu,
Emine Bahar Bingoler Pekcici,
Elcin Caglar,
Omer Erdeve,
Begüm Atasay,
Saadet Arsan

摘要

To evaluate the effect of intact cord milking (I-UCM) compared to immediate cord clamping (ICC) on neurodevelopmental outcomes at seven years of age in very preterm infants. This prospective single-blind cohort study included children who were previously participated in a randomized controlled trial comparing I-UCM and ICC. At about 7 years of age, participants were administered the Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) and the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). A total of 31 children were included in the follow-up study. The mean age of participants was 6.4 ± 0.5 years. The mean gestational age at birth was 28.5 ± 1.7 weeks. There were no cases with grade ≥ 3 intraventriculary hemorrhage (IVH) in the present study cohort. Although the I-UCM group showed a trend toward higher median full-scale IQ, the difference was not statistically significant (p: 0.057). A significantly higher percentage of cases in the I-UCM group achived a full-scale IQ above 85 in the WISC-IV (p = 0.048). The mean of the "written language scaled score" subdomain among Vineland-II scores was found to be significantly higher in the I-UCM group. A significantly higher percentage of cases in the I-UCM group had a written language scaled score above 12 (p: 0.029).

Conclusion: A comparison of I-UCM with ICC in preterm infants born at a mean age of 28 weeks and without severe IVH revealed that I-UCM did not result in long-term neurodevelopmental adverse outcomes. I-UCM even had positive effects in some subdomains of detailed neurodevelopmental tests.

What is Known:

• Compared to immediate cord clamping, umbilical cord milking improves the short-term postnatal outcomes of very preterm infants. There is a lack of robust data regarding the long-term neurodevelopmental effects of umbilical cord milking in preterm infants.

What is New:

• Among very preterm infants without severe intraventricular hemorrhage, intact umbilical cord milking was not associated with long-term adverse neurodevelopmental outcomes. Intact-umbilical cord milking even had positive effects in some subdomains of detailed neurodevelopmental tests.