142 The effect of umbilical cord milking on neurodevelopmental outcomes of preterm infants at 36 months of age: a randomized controlled trial

Abstract

BACKGROUND: Umbilical cord milking at birth has been reported to have short-term benefits to preterm infants. Long-term neurodevelopmental outcomes need more exploration. OBJECTIVE(S): To compare the effects of cord milking (CM) vs. early cord clamping (ECC) at birth on neurodevelopmental outcomes at 36 months corrected age. DESIGN/METHODS: Preterm infants <31 weeks' gestation who were randomized to receive CM or ECC at birth, were evaluated at 36 months corrected age. Neuro-developmental outcomes were assessed by blinded examiners using Bayley Scales of Infant and Toddler Development (version III). Intention-to-treat was used for primary analyses. RESULT(S): Out of the 74 infants included in the original trial, 2 died and 65 (90%) infants were evaluated at 36 months corrected age. Patients' characteristics were similar in both study groups except for higher hemoglobin concentration on NICU admission (p=0.02) and longer duration of phototherapy (p=0.02) in the CM group (Table 1). The median cognitive, motor or language scores were higher in the CM group but the difference didn't reach statistical significance (Table 2). Similarly, there were no significant differences in the rates of cerebral palsy, developmental impairment, deafness or blindness though cerebral palsy was higher in the CM group. CONCLUSION(S): In this randomised controlled trial, no significant differences in neuro-developmental outcomes at 36 months corrected age, were found between preterm infants who received CM and those who received ECC at birth. The absence of difference may be attributed to the small sample size. Larger trials are needed to evaluate the neuro-developmental outcomes of CM. (Table Presented).