Effect of Umbilical Cord Milking in Term and Late Preterm Neonates: A Randomized Controlled Trial
Anand Kumar Kumawat, Kailash Kumar Meena, Vivek Athwani, Sunil Gothwal, Manohar Lal Gupta, Sadasivam Sitaraman, Ghanshyam Bairwa
Abstract
Aim: To investigate the effect of umbilical cord milking (UCM) on hematologic parameters at 10 to 14 weeks in term and late preterm neonates
Materials and Methods: This randomized controlled trial was conducted at the Department of Pediatrics, Sawai Man Singh Medical College (Jaipur, Rajasthan, India), from 2016 to 2017. Neonates born at gestational age ≥ 34 weeks were included in this study, and 84 neonates were randomly allocated to each group: UCM group (intervention group) and early cord clamping (ECC; control group). The main outcome measure was to evaluate the effect of UCM on hemoglobin (Hb) and serum ferritin levels at 10 to 14 weeks of age and compare these values with that in the ECC group. In both the groups, the neonates were managed as per the standard protocol. The data were statistically analyzed using the unpaired t test and the Χ2 test or Mann–Whitney U test.
Results: At the end of the study, 67 neonates in the intervention group and 69 neonates in the control group were analyzed. In the early neonatal period, the baseline characteristics and hemodynamic parameters were comparable in both the groups. Iron stores (serum ferritin level) were significantly higher in the intervention group than that in the control group. But Hb levels were slightly higher in the intervention group at 10 to 14 weeks of age (P = .22). UCM did not have a significant effect on serum bilirubin level and icterus requiring phototherapy in the initial 48 hours of life.
Conclusions: UCM significantly improved iron stores in term and late preterm neonates at 10 to 14 weeks of age. Further studies with a longer follow-up duration are required to determine whether the short-term benefits of UCM translate to long-term benefits.
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