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Delayed Cord Clamping in Very Low Birth Weight Infants

Not Applicable
Terminated
Conditions
Intraventricular Hemorrhage
Very Low Birth Weight Infants
Premature Infants
Registration Number
NCT02337088
Lead Sponsor
University of Chicago
Brief Summary

The purpose of this study is to determine if there is a difference in neonatal outcomes with delayed umbilical cord clamping at 30 versus 60 seconds. Our primary outcome will be intraventricular hemorrhage (IVH) (bleeding in the brain) in these infants.

Detailed Description

Immediately following delivery, up to 40% of the total blood volume available to the infant is in the placenta. Over a period of 30 seconds to 3 minutes, a significant portion of this blood is transferred to the infant through the umbilical cord. Delayed cord clamping following delivery facilitates this transfer of blood.

Preterm infants are very susceptible to the effects of anemia and hypovolemia. A recent meta-analysis showed that a brief delay in umbilical cord clamping (30-60 seconds) decreases the risk of anemia, blood transfusion, intraventricular hemorrhage, necrotizing enterocolitis, and the need for blood pressure support after delivery. The same meta-analysis showed no impact on Apgar scores or hypothermia due to a brief delay in resuscitation efforts to allow delayed cord clamping.

Preterm infants are at significant risk for IVH and as high as 20% of very low birth weight infants will have it. IVH is an important cause of brain injury in these infants. In our study, we would like to determine the optimal timing of delayed cord clamping in order to prevent IVH in these infants.

Recruitment & Eligibility

Status
TERMINATED
Sex
Female
Target Recruitment
39
Inclusion Criteria
  • Pregnant women who are expected to deliver a very low birth weight infant
  • Neonates born weighing >= 500g and <1500 grams
  • Mother 18 years of age or older
  • English speaking mother
Exclusion Criteria
  • Placental abruption
  • Vasa previa
  • Fetal hydrops or other signs of fetal volume overload
  • Other major fetal anomalies
  • Placenta Accreta
  • Mother < 18 years of age
  • Non-English speaking mother
  • Infants >= 1500g (3.3 lbs) or <500g

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Intraventricular hemorrhageDuring NICU admission up to 6 months

Neonates will be followed for up to 6-months during NICU admission to assess for the development of intraventricular hemorrhage.

Secondary Outcome Measures
NameTimeMethod
Bilirubin levelsDuring NICU admission up to 6 months

Neonates will be followed for up to 6-months and assessed for clinical jaundice.

Hemoglobin and hematocritDuring NICU admission up to 6 months

Neonates will be followed for up to 6-months and initial H/H will be recorded.

Need for blood transfusionDuring NICU admission up to 6 months

Neonates will be followed for up to 6-months and assessed for clinical or laboratory evidence of need for transfusion.

Delivery room temperatureDelivery

Neonates will be assessed for hypothermia at the time of delivery.

Trial Locations

Locations (1)

University of Chicago Medical Center

🇺🇸

Chicago, Illinois, United States

University of Chicago Medical Center
🇺🇸Chicago, Illinois, United States

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