A randomized controlled trial to evaluate the role of brief delay in cord clamping in preterm neonates (34-36 weeks) on shortterm neurobehavioural outcome

Abstract

The effects of a brief delay in cord clamping on the neurobehaviour of late preterm infants are largely unknown. It is hypothesized that a brief delay in cord clamping will have beneficial effects on the neurobehavioural outcome of such neonates. Aim: To study the effect of brief delay in cord clamping on short-term neurobehavioural outcome of preterm neonates. Methods: All preterm neonates born between 34-36 weeks and 6 days were included and randomized into either a control or intervention group. In the control group, clamping was done within 20 s after delivery, and this was termed as immediate cord clamping (ICC). In the intervention group, delayed cord clamping (DCC) took place between 30 and 60 s. A total of 120 preterm neonates were enrolled. The primary outcome studied was short-term neurobehavioural outcome at 37 weeks after conceptional age using the Neurobehavioral Assessment of Preterm Infants (NAPI) score as the outcome measure. Results: NAPI scores at 37 weeks of corrected gestational age revealed a mean (95% confidence interval) score of motor development and vigour of 64.21±27.31 (57.27-71.14) vs. 76.69±25.29 (70.04-83.34), p=0.01; and alertness and orientation of 29.31±12.78 (26.06-32.55) vs. 42.77±15.75 (38.63-46.91), p=0.00 across the ICC vs. DCC groups, respectively. Conclusion: A brief delay of 30-60 s in cord clamping is beneficial in improving neurobehavioural outcome of late preterm infants.