What does this research mean for the field?

Delayed cord clamping (DCC) results in transiently higher cerebral oxygenation (rSO2C) in preterm infants compared to umbilical cord milking (UCM) during the first 24 hours of life. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study investigates how delayed cord clamping (DCC) and umbilical cord milking (UCM) affect cerebral oxygenation and cardiovascular function in preterm infants during the first 24 hours of life.

February 19, 2026Open Access

Effect of delayed cord clamping and cord milking on cerebral oxygenation and cardiovascular function: a secondary analysis of the PCI trial

Key Points

This study investigates how delayed cord clamping (DCC) and umbilical cord milking (UCM) affect cerebral oxygenation and cardiovascular function in preterm infants during the first 24 hours of life.
Conducted a post-hoc secondary analysis of the PCI trial across 8 neonatal intensive care units.
Included 105 infants who received DCC and 104 who received UCM during resuscitation.
Measured cerebral regional tissue oxygenation via near-infrared spectroscopy at specified time points (3, 6, 12, 18, and 24 hours).
Assessed cardiovascular function through echocardiography within the first 24 hours of life.
Cerebral oxygenation (rSO2C) was higher at 3 hours (79% vs 78%, P = 0.04) and 12 hours (79% vs 78%, P = 0.01) in the DCC group compared to UCM.
Left ventricular output was lower in the DCC group (196 ml/Kg/min vs 232 ml/Kg/min, P = 0.02).
No significant differences in right ventricular output and superior vena cava flow.
Higher need for dopamine in the DCC group (26% vs 23%, P = 0.02).

Abstract

Abstract Umbilical cord clamping management may affect cerebral oxygenation (rSO 2 C), but previous studies have only investigated effects in the first minutes of life. Our objective was to determine whether delayed cord clamping (DCC) and umbilical cord milking (UCM) differently affect cerebral oxygenation and cardiovascular function in the first 24 h of life in preterm infants. A post-hoc secondary outcome analysis of a multicentre prospective randomised clinical trial (PCI), conducted between April 2016 and February 2023 at 8 Italian neonatal intensive care units. The present ancillary study included preterm infants with 23 +0 –29 +6 30 weeks’ gestation. One hundred and five infants received DCC and 104 UCM during resuscitation. Cerebral regional tissue oxygenation (rSO 2 C) was measured by near-infrared spectroscopy (NIRS) at 3 (T 3h ), 6 (T 6h ), 12 (T 12h ), 18 (T 18h ), and 24 (T 24h ) hours of life. Cardiovascular function was assessed by echocardiography within the first 24 h of life. We found that rSO 2 C was higher at T 3h 79 (76–84) vs. 78% (74–82), P = 0.04) and T 12h 79 (76–83) vs. 78% (74–80), P = 0.01 in the DCC than in the UCM group. Left ventricular output (LVO) was lower 196 (182–301) vs. 232 (182–301) ml/Kg/min, P = 0.02 in the DCC than in the UCM group, while right ventricular output (RVO) and superior vena cava (SVC) flow were similar. The need for dopamine was higher (26 vs. 23%, P = 0.02) in the in the DCC than in the UCM group. Conclusion : rSO 2 C was transiently higher in preterm infants resuscitated with DCC in comparison with UCM, but this difference was not clinically relevant. The lower LVO value in the DCC group compared to the UCM group deserves further studies to be confirmed and interpreted. What is Known: • Umbilical cord clamping management may affect cerebral oxygenation (rSO 2 C) .• Previous studies showed no differences of brain oxygenation in the first minutes of life due to different timing of cord clamping or umbilical cord milking (UCM) . What is New: • We showed that rSO 2 C was transiently higher in preterm infants resuscitated with delayed cord clamping (DCC) in comparison with UCM during the first day of life .• We found a lower left ventricular output in the DCC group compared to the UCM group, which deserves confirmation and interpretation .

KI fragen

Bookmark

View Full Paper