Oxygenation associated with cord management strategies among preterm infants <32 weeks gestation during the transition period

J Perinatol. 2025 Jan;45(1):55-62. doi: 10.1038/s41372-024-02127-7. Epub 2024 Oct 11.

Abstract

Objective: Compare changes in SpO2 and FiO2 post-birth among preterm infants after delayed cord clamping (DCC), umbilical cord milking (UCM) or early cord clamping (ECC).

Study design: Retrospective study of infants <32 weeks gestation born between 2014 and 2021. ECC was clamping 0-59 s, DCC was clamping ≥60 s after delivery, UCM defined as milking the intact umbilical cord several times before clamping.

Results: Of 463 infants; 257 received DCC, 168 received UCM, 38 received ECC. UCM infants had higher median SpO2 values at 4-(79% UCM vs 69% DCC, p = 0.027) and 5-(85% UCM vs 80% DCC, p = 0.023) minutes after-birth compared to DCC. DCC and UCM infants required lower FiO2 levels in the first 5-minutes compared to ECC infants (DCC 0.38 ± 0.17, UCM 0.40 ± 0.20 vs ECC 0.51 ± 0.27, p's <0.001).

Conclusion: The proportion of infants achieving SpO2 ≥ 80% by 5 min was similar in all groups, FiO2 needed to achieve this goal was higher in ECC infants.

MeSH terms

  • Female
  • Gestational Age*
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Male
  • Oxygen / blood
  • Pregnancy
  • Retrospective Studies
  • Time Factors
  • Umbilical Cord
  • Umbilical Cord Clamping*

Substances

  • Oxygen