Delayed Cord Clamping in Premature Infants

Delayed cord clamping has been shown to decrease the risk of bleeding in the brain of premature infants. However this procedure is not standard due to concerns that the premature infant will get too cold. In this study the investigators look at using a plastic covering and a chemical warmer to keep the small premature baby warm while waiting 30-60 seconds to clamp the umbilical cord.

Enrolled premature infants will be compared to age matched historical controls that did not receive delayed cord clamping but were placed under a warmer immediately after birth. Outcomes to be analyzed include initial body temperature, hematocrit at birth and 24 hours of age, number of red blood cell transfusions during hospital stay, umbilical cord gas, first blood gas following delivery, blood pressure data in the first 24 hours, fluid bolus and inotrope requirement in the first 24 hours, incidence of intraventricular hemorrhage and late-onset sepsis, peak bilirubin level, length of phototherapy, and Apgar scores.

delayed cord clamping, premature infants, hypothermia, anemia, intraventricular hemorrhage, Anemia in premature infants

Infants will be covered with plastic and placed on a chemical warmer at delivery and then clamping of the umbilical cord will be delayed for 30-60 seconds.

Inclusion Criteria: premature infants at 24-28 completed weeks gestation at the time of delivery informed consent obtained from parents prior to delivery Exclusion Criteria: multiple gestation (twins, triplets, etc) prolonged fetal bradycardia placental abruption or previa maternal illness major congenital anomalies maternal fever in labor fetal illness (e.g. isoimmune hemolysis)