Commentary: Association of Umbilical Cord Milking vs. Delayed Umbilical Cord Clamping With Death or Severe Intraventricular Hemorrhage Among Preterm Infants

摘要

The quality of care in the first “golden” minutes of life of a newborn, especially if born preterm, can profoundly influence later-life outcomes. A meta-analysis of 12 randomized controlled trials demonstrated that placental transfusion strategies (both delayed cord clamping and cord milking performed at birth) vs. immediate cord clamping significantly reduced intraventricular hemorrhage and mortality in preterm newborn less than 31 weeks gestation (1). Two metaanalyses demonstrated that cord milking or delayed cord clamping compared with immediate cord clamping in premature newborns was associated with a reduced risk of all-grade intraventricular hemorrhage or mortality, respectively (2, 3). Thus, both delayed cord clamping and cord milking at birth seem to be protective compared with immediate cord clamping in preterm newborns. Instead, immediate cord clamping is still a routine care at birth performed worldwide, above all in very preterm newborns.