The Study on Umbilical Cord Milking to Prevent and Decrease the Severity of Anemia in Preterms

NCT ID: NCT03023917

Last Updated: 2020-10-27

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

284 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-06-30

Study Completion Date

2019-12-31

Brief Summary

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The overall objective of the present study is to examine the effects of umbilical cord milking at birth in preterm infants to prevent and decrease anemia using a multi-center prospective randomized controlled trial comparing immediate cord clamping (standard at present) with umbilical cord milking.

Detailed Description

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Anemia is a significant problem for pre-term infants and a major risk factor for preterm babies mortality and morbidity in neonatal intensive care unit(NICU). the majority of pre-term babies will require one or more blood transfusions during in NICU. Blood transfusion is a safe procedure but like all therapeutic interventions has risks associated with it and effort is made to reduce the number of transfusions that infants require during their stay on the neonatal unit.

Delayed cord clamping has a beneficial effect on prevention of anemia in later infancy because of increased iron stores at birth. However there are controversies in incorporating delayed cord clamping practice in the management of third stage of labour globally. Concerning about the need for urgent resuscitation and temperature management, attendants encouraged to clamp the umbilical cord immediately so that post-natal resuscitation and care can start as soon as possible.However,umbilical cord milking allows for swift intervention and resuscitation and attention to thermal care and should take less than 10 seconds to complete.

The specific aim of this study is to investigate the effects of umbilical cord milking on preventing and decreasing anemia in very pre-term infants.

Primary Outcomes:

Hemoglobin (Hb), Hematocrit (Hct) and serum iron levels at birth, at 1 week,at 2 weeks of age.

Secondary Outcomes:

* Hemoglobin,hematocrit levels at 6 months of age.
* Anemia at 1 week of life and 6 months follow-up, defined as hemoglobin levels below the respective cutoffs.
* number of blood transfusions until 3 months corrected gestational age (CGA).
* short term clinical profile of neonates like jaundice, polycythemia etc.
* preterm infant complications such as lung function as assessed by oxygen dependency at 36 weeks corrected gestational age (CGA), and cardiovascular function as assessed by the need for volume expansion, inotropes, or clinically suspected patent ductus arteriosus(PDA )requiring intervention prior to discharge home,incidence of intraventricular hemorrhage and late-onset sepsis,etc.

Conditions

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Anemia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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umbilical cord clamping immediately

Umbilical cord was clamped immediately, or as close as possible, after delivery of the infant's shoulders. (This was standard practice in the study hospital, thus it served as the "control" group).

Group Type ACTIVE_COMPARATOR

umbilical cord clamping immediately

Intervention Type PROCEDURE

umbilical cord was cut immediately after birth

umbilical cord milking

preterm baby were placed at or below level of the placenta and about 25cm of the umbilical cord was vigorously milked towards the umbilicus two to three times before clamping the cord. The milking speed was about 25cm/2 seconds

Group Type EXPERIMENTAL

umbilical cord milking

Intervention Type PROCEDURE

Infants were placed at or below level of the placenta and about 25cm of the umbilical cord was vigorously milked towards the umbilicus two to three times before clamping the cord. The milking speed was about 25cm/2 seconds

Interventions

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umbilical cord milking

Infants were placed at or below level of the placenta and about 25cm of the umbilical cord was vigorously milked towards the umbilicus two to three times before clamping the cord. The milking speed was about 25cm/2 seconds

Intervention Type PROCEDURE

umbilical cord clamping immediately

umbilical cord was cut immediately after birth

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Women in labour or with a plan for delivery at a gestational age less than 34 weeks gestation.
* Singleton pregnancy
* informed consent was obtained from the parent

Exclusion Criteria

* Multiple gestation
* Diagnosis of any of the following in the current pregnancy: hemorrhage requiring clinic/hospital admission, placental abnormalities, fetal anomalies, Down's syndrome of the fetus,anemia
* Diagnosis of pre-eclampsia or eclampsia in current or previous pregnancies
* Diagnosis at any time for the mother of any of the following: serious Diabetes, serious hypertension, chronic renal disease
* Infant with major congenital malformation
* Infant with blood disease
* Unwilling to return for follow-up study visits at the hospital
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shanghai First Maternity and Infant Hospital

OTHER

Sponsor Role collaborator

Yangpu District Central Hospital Affiliated to Tongji University

OTHER

Sponsor Role collaborator

Xinhua Hospital, Shanghai Jiao Tong University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Lijuan Xie

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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guangyu chen

Role: STUDY_CHAIR

Xinhua Hospital, Shanghai Jiao Tong University School of Medicine

Locations

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Xinhua Hospital

Shanghai, Shanghai Municipality, China

Site Status

Countries

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China

Other Identifiers

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XH-16-050

Identifier Type: -

Identifier Source: org_study_id