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PO-0466 3.5 Year Neurodevelopmental Outcome Of Preterm Infants Randomised To Delayed Cord Clamping (dcc) Or Milking Of The Cord (mc)
  1. H Rabe1,
  2. A Sawyers2,
  3. P Amess1,
  4. E Emery1,
  5. S Ayers3
  1. 1Neonatology, Royal Sussex County Hospital, Brighton, UK
  2. 2School of Psychology, University of Sussex, Brighton, UK
  3. 3School of Psychology, City University of London, London, UK

Abstract

Background Placental transfusion at birth either facilitated by DCC or MC has been described to reduce intraventricular haemorrhage and donor blood transfusion in preterm infants. Few studies have reported on neurodevelopmental outcomes.

Aims To assess neurodevelopmental outcome of ex-preterm survivors (< 33 weeks gestation) enrolled into our randomised trial of DCC (30 seconds) versus 4 times MC (Rabe Obstet and Gynecol 2011) at 3.5 years corrected age with Bayley-III examination.

Methods Prospective cohort study. Results were analysed by a statistician blinded to the group allocation using ANCOVA (significance level at the. 05 alpha).

Results Bayley-III assessments were obtained in 29/ 51 survivors (56%). The MC group (9 male, 9 female) performed better on language (115 SD18 vs 105 SD23), cognitive (127 SD20 vs 120 SD27) and motor (113 SD23 vs 108 SD21) subscales than the DCC group (5 male, 6 female), which did not reach statistical significance.

Conclusions Only one study (Mercer 2010) reported a better neurodevelopmental outcome at 7 months of age for preterm infants receiving placental transfusion via DCC. To our knowledge this is the first report on 3.5 year follow-up in infants with DCC or MC. Our results indicate that MC could safely be used as an alternative to DCC. There were no excess events of typical prematurity related co-morbidities in the MC group. Ex-preterm infants seem to benefit from MC and DCC in their neurodevelopmental outcome. Large studies are needed to confirm the findings.

The study is reported on behalf of the Brighton Perinatal Study Group.

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