Effects of Delayed Cord Clamping in Very Low Birth Weight Infants

NCT ID: NCT00840983

Last Updated: 2015-11-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

72 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-08-31

Study Completion Date

2006-12-31

Brief Summary

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The purpose of this study was to see if a brief delay in cord clamping for 30 to 45 seconds would result in higher hematocrit levels, fewer transfusions, healthier lungs, and better motor function at 40 wks and 7 months of age.

Detailed Description

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When cord clamping is delayed at birth or the cord is milked, infants receive a placental transfusion of 10-15 mL/kg during the first few minutes of life. This additional blood improves hemodynamic stability and may reduce the risk of intraventricular hemorrhage (IVH) and the vulnerability of infants to inflammatory processes. This blood also contains stem cells that are important in repairing tissue and building immunocompetence.

The current randomized controlled trial prospectively tested the effects of DCC for 30-45 seconds followed by 1 cord milking with the aim of confirming our prior work and providing long-term follow-up. Our a priori hypotheses were that DCC would reduce the incidence of IVH, LOS, and result in better motor function at 18-22 months.

Conditions

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Bronchopulmonary Dysplasia Necrotizing Enterocolitis Intraventricular Hemorrhage Late Onset Neonatal Sepsis Motor Skills Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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1-Immediate Cord Clamping

infants received the routine care of immediate clamping of the umbilical cord

Group Type NO_INTERVENTION

No interventions assigned to this group

2-Delayed Cord Clamping

after birth, cord clamping was delayed 30 to 45 seconds while infant was held lower than the level of the placenta.

Group Type EXPERIMENTAL

delayed cord clamping

Intervention Type PROCEDURE

cord clamping was delayed for 30 to 45 seconds and infant was held lower than the level of the placenta

Interventions

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delayed cord clamping

cord clamping was delayed for 30 to 45 seconds and infant was held lower than the level of the placenta

Intervention Type PROCEDURE

Other Intervention Names

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cord clamping time

Eligibility Criteria

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Inclusion Criteria

* Women pregnant with gestation 24 to 31.6 weeks of singleton pregnancy by obstetrical evaluation
* Obstetrician's approval of enrollment into study
* Parental consent
* Any mode of birth will be included

Exclusion Criteria

* Obstetrician's refusal to enroll infants
* Parental refusal for consent
* Prenatally-diagnosed major congenital anomalies \[or multiple gestations\]
* Intent to withhold or withdraw care
* Severe or multiple maternal illnesses, frank vaginal bleeding, placenta abruption or previa
* Mothers who are institutionalized or psychotic
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Nursing Research (NINR)

NIH

Sponsor Role collaborator

Thrasher Research Fund

OTHER

Sponsor Role collaborator

University of Rhode Island

OTHER

Sponsor Role lead

Responsible Party

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Judith S Mercer

Professor Emerita

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Judith S Mercer, PhD, CNM

Role: PRINCIPAL_INVESTIGATOR

University of Rhode Island

Locations

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Women & Infants Hospital

Providence, Rhode Island, United States

Site Status

Countries

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United States

References

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Mercer JS, Vohr BR, McGrath MM, Padbury JF, Wallach M, Oh W. Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial. Pediatrics. 2006 Apr;117(4):1235-42. doi: 10.1542/peds.2005-1706.

Reference Type BACKGROUND
PMID: 16585320 (View on PubMed)

Mercer JS, Vohr BR, Erickson-Owens DA, Padbury JF, Oh W. Seven-month developmental outcomes of very low birth weight infants enrolled in a randomized controlled trial of delayed versus immediate cord clamping. J Perinatol. 2010 Jan;30(1):11-6. doi: 10.1038/jp.2009.170. Epub 2009 Oct 22.

Reference Type BACKGROUND
PMID: 19847185 (View on PubMed)

Mercer JS, Erickson-Owens DA, Vohr BR, Tucker RJ, Parker AB, Oh W, Padbury JF. Effects of Placental Transfusion on Neonatal and 18 Month Outcomes in Preterm Infants: A Randomized Controlled Trial. J Pediatr. 2016 Jan;168:50-55.e1. doi: 10.1016/j.jpeds.2015.09.068. Epub 2015 Nov 4.

Reference Type RESULT
PMID: 26547399 (View on PubMed)

Other Identifiers

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R01NR010015-01A2

Identifier Type: NIH

Identifier Source: secondary_id

View Link

Mercer-K23-03

Identifier Type: -

Identifier Source: org_study_id