Umbilical Cord Milking Versus Early Cord Clamping to Reduce Death in Preterm Infants Born Between 30 and 34 Weeks Who Are Non-vigorous at Birth

What this Trial Is About

This research aims to determine 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. Prematurity is a leading cause of death in young children worldwide, especially in low-resource countries, and this study focuses on a simple intervention that might improve survival in this vulnerable group. The trial compares two methods used immediately after birth milking the umbilical cord four times before clamping versus clamping the cord early within 60 seconds. Milking involves pushing blood through the cord into the infant and is done quickly by the delivery team. About 800 preterm infants will be randomly assigned to one of these two approaches in a multicenter, cluster-randomized crossover design. Participants will be monitored in the hospital from birth until discharge or death, up to 12 weeks. Researchers will track mortality and various health outcomes such as hemoglobin levels, infections, brain hemorrhages, need for blood transfusions, jaundice treatment, and length of hospital stay. This study aims to provide important evidence on the safety and effects of umbilical cord milking in preterm newborns who need immediate resuscitation.

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