Longer duration of deferred cord clamping improves preterm survival without major morbidities

Background:  Longer duration of deferred cord clamping (DCC) at least 120 seconds is associated with the highest reduction in mortality compared to shorter durations of DCC or immediate cord clamping in preterm infants.  We compared the neonatal outcomes of very preterm infants who received at least 60 seconds to those who received at least 120 seconds of DCC. 

Methods:  This is a retrospective single-center study including preterm infants born <33 weeks of gestational age (GA) between 2014 and 2019.  The intended duration of DCC was 60 seconds in Period 1 (January 2014 to June 2016, n=139) and 120 to 180 seconds in Period 2 (July 2016 to December 2019, n=155).  We compared the demographics, delivery room measures, and neonatal outcomes between the two periods as intent to treat analysis and per protocol analysis.  

Results:  The intended duration of DCC was completed in 75% of infants in Period 1 (n=106) and 76% of infants in Period 2 (n-114). There was an increase in survival without major morbidities in the infants that received at least 120 seconds of DCC which remained significant after adjusting for GA and erythropoietin use (Odds ratio 8.6, 95% CI 1.6 to 45.7). 

Conclusion: Longer duration of DCC is associated with improved survival without major morbidities in preterm infants <33 weeks GA.

Methods
The data was collected from electronic medical records and data stored in NICU database.  The data was pocessed in Excel spreadsheet.