Effects of umbilical cord milking versus delayed cord clamping on cerebral oxygenation and ductus arteriosus closure in preterm infants: RCT

Background Delayed cord clamping (DCC) and umbilical cord milking (UCM) are placental transfusion techniques that improve oxygen delivery and cardiac output. UCM enhances cerebral oxygenation without delaying resuscitation. Functional closure of the ductus arteriosus (DA) usually occurs within 48 hours after birth in full-term infants, with a high incidence of persistent DA in premature infants. Objective To investigate the effects of UCM and DCC on functional ductus arteriosus closure and cerebral tissue oxygenation. Methods This randomized controlled clinical trial included 100 preterm infants who were allocated to either the UCM group ( n = 50) or the DCC group ( n = 50). crSO 2 and cfTOE were measured after resuscitation and at 12, 24, and 48 hours of life. Echocardiography was performed at 6, 12, 18, 24, and 48 hours of life to assess functional DA closure. Results Repeated-measures analysis showed no statistically significant between-group differences in changes in crSO 2 (P = 0.194), cfTOE (P = 0.140), or functional DA closure (P = 0.372). Conclusion UCM and 60-second DCC showed no statistically significant differences in cerebral tissue oxygenation improvement or functional ductus arteriosus closure during the first 48 hours of life.