The PREMOD Trial: A Randomized Controlled Trial of Umbilical Cord Milking vs. Delayed Cord Clamping in Premature Infants

NCT ID: NCT01866982

Last Updated: 2018-05-24

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

NA

Total Enrollment

197 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-07-02

Study Completion Date

2018-01-10

Brief Summary

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Premature babies can be very sick and have bleeding in the brain. Giving babies more blood before cutting the umbilical cord by delayed cord clamping or umbilical cord milking has been shown to reduce the risk of bleeding in the brain. This may be related to improving perfusion to the brain. However, some studies suggest that delayed cord clamping may not increase hemoglobin or blood volume in babies delivered by cesarean section. Milking the umbilical cord may give more blood in babies delivered by Cesarean Section may improve perfusion and reduce bleeding in the brain.

Detailed Description

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Conditions

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Intraventricular Hemorrhage

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Investigators

Study Groups

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Umbilical Cord Milking

Milking the umbilical cord 4 times towards the infants at a speed of 20cm/2 seconds

Group Type ACTIVE_COMPARATOR

Umbilical Cord Milking

Intervention Type PROCEDURE

Umbilical cord milked toward the neonate four times at a speed of 20cm/2seconds, prior to clamping and cutting umbilical cord. Procedure takes about 10-20 seconds.

Delayed Cord Clamping

Delayed clamping of the umbilical cord for 45-60 seconds

Group Type ACTIVE_COMPARATOR

Delayed Cord Clamping

Intervention Type PROCEDURE

Performed by positioning the baby 20 cm below the placenta for 45-60 seconds prior to umbilical cord clamping and cutting.

Interventions

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Umbilical Cord Milking

Umbilical cord milked toward the neonate four times at a speed of 20cm/2seconds, prior to clamping and cutting umbilical cord. Procedure takes about 10-20 seconds.

Intervention Type PROCEDURE

Delayed Cord Clamping

Performed by positioning the baby 20 cm below the placenta for 45-60 seconds prior to umbilical cord clamping and cutting.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Singleton or multiples pregnancies in patients admitted for medically indicated delivery or in advanced spontaneous preterm labor with imminent delivery at 23 0/7 - 31 6/7 weeks gestation

Exclusion Criteria

* Planned vaginal breech delivery
* Major fetal abnormalities (defined as those that are lethal or require prenatal or postnatal surgery)
* Fetal death in utero
* Red cell isoimmunization
* Patients who are incapable of informed consent (unconscious, severely ill, mentally handicapped), or are unwilling to undergo randomization
* Placenta accreta or abruption
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

Sharp HealthCare

OTHER

Sponsor Role lead

Responsible Party

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Anup Katheria, M.D.

Director of Neonatal Research

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Anup C Katheria, MD

Role: PRINCIPAL_INVESTIGATOR

Sharp HealthCare

Locations

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Loma Linda Medical Center

Loma Linda, California, United States

Site Status

Sharp Mary Birch

San Diego, California, United States

Site Status

University of California, San Diego

San Diego, California, United States

Site Status

Countries

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United States

References

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Katheria AC, Truong G, Cousins L, Oshiro B, Finer NN. Umbilical Cord Milking Versus Delayed Cord Clamping in Preterm Infants. Pediatrics. 2015 Jul;136(1):61-9. doi: 10.1542/peds.2015-0368.

Reference Type BACKGROUND
PMID: 26122803 (View on PubMed)

Katheria A, Garey D, Truong G, Akshoomoff N, Steen J, Maldonado M, Poeltler D, Harbert MJ, Vaucher YE, Finer N. A Randomized Clinical Trial of Umbilical Cord Milking vs Delayed Cord Clamping in Preterm Infants: Neurodevelopmental Outcomes at 22-26 Months of Corrected Age. J Pediatr. 2018 Mar;194:76-80. doi: 10.1016/j.jpeds.2017.10.037. Epub 2017 Dec 12.

Reference Type BACKGROUND
PMID: 29246467 (View on PubMed)

Other Identifiers

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R03HD072934-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

PREMOD

Identifier Type: -

Identifier Source: org_study_id

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