A Cluster Randomized Clinical Trial of Umbilical Cord Milking Compared to Early Cord Clamping in Preterm Infants Who Are Non-vigorous at Birth

What this Trial Is About

Prematurity is a leading cause of death in children under 5 years old, with about 15 million infants born premature worldwide each year. This trial is studying whether umbilical cord milking, compared to early cord clamping, can reduce in-hospital death rates in non-vigorous preterm infants born between 30 and 34 weeks of gestation. The research aims to provide evidence to support changes in delivery room practices to improve survival of these infants. The study compares two approaches at birth: umbilical cord milking and early cord clamping. In cord milking, the healthcare provider will milk the umbilical cord four times to push blood toward the infant before clamping, which takes about the same time as early clamping. The newborn is placed below the incision level during cesarean or held close after vaginal delivery while the cord is milked. Early cord clamping involves clamping the cord immediately within 60 seconds after birth. About 800 preterm infants will be randomly assigned to one of these two groups. Participants will be monitored from birth until hospital discharge or up to 12 weeks. Researchers will measure outcomes including in-hospital mortality, hemoglobin levels, infections, brain hemorrhage, need for blood transfusions and medications, jaundice treatment, retinopathy, and length of hospital stay. This study includes multiple centers and aims to gather detailed clinical data to assess the impact of the cord milking procedure.

Comparative Outcomes Related to Delivery-room Cord Milking In Low-resourced Kountries- PreTerm