Does intact umbilical cord milking increase infection rates in preterm infants with premature prolonged rupture of membranes?

Abstract

Objective: To investigate whether intact umbilical cord milking (I-UCM) can aggravate infection or result in other undesirable complications in preterm infants with premature prolonged rupture of membranes (PPROM).

Methods: Neonates vaginally delivered between 28 and 37 weeks’ gestation and complicated by PPROM before birth were randomly divided into two groups according to the cord clamping procedure: I-UCM before clamping and immediate cord clamping (ICC). Various parameters of the study participants were compared between the two groups.

Results: Of 102 preterm infants, 48 and 54 were randomly allocated to the I-UCM and ICC groups, respectively. There were no significant differences between the two groups regarding hematological parameters (platelet count, white blood count, neutrophil ratio, and C-reactive protein) or neonatal outcomes (probable or certain neonatal infection, respiratory distress syndrome, necrotizing enterocolitis, and intraventricular hemorrhage) (p > .05). However, preterm neonates in the I-UCM group had higher serum hemoglobin and hematocrit levels (p < .05) and received fewer blood transfusions (p < .05) than those in the ICC group.

Conclusion: Milking the umbilical cord to a preterm neonate with PPROM will not aggravate neonatal infection or result in other undesirable complications. This simple procedure will improve hemoglobin values and hematocrit levels and may lessen the need for transfusion during the neonatal period.

Keywords:

• Immediate cord clamping (ICC)
• intact umbilical cord milking (I-UCM)
• neonatal outcomes
• premature prolonged rupture of membranes (PPROM)
• preterm infants

Ethical approval

This trial was approved by the institutional ethical committee and informed consent was obtained before the delivery from each expectant mother and/or her spouse.

Acknowledgments

We are especially grateful to the obstetricians, midwives, doctors and nurses of the NICU for their excellent technical assistance. We also thank the parents who gave consent for the inclusion of their babies in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.