Effects of Delayed Cord Clamping in Very Low Birth Weight Infants

November 27, 2015 updated by: Judith S Mercer, University of Rhode Island

Effects of Delayed Cord Clamping in Very Low Birth Weight (VLBW) Infants

The purpose of this study was to see if a brief delay in cord clamping for 30 to 45 seconds would result in higher hematocrit levels, fewer transfusions, healthier lungs, and better motor function at 40 wks and 7 months of age.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

When cord clamping is delayed at birth or the cord is milked, infants receive a placental transfusion of 10-15 mL/kg during the first few minutes of life. This additional blood improves hemodynamic stability and may reduce the risk of intraventricular hemorrhage (IVH) and the vulnerability of infants to inflammatory processes. This blood also contains stem cells that are important in repairing tissue and building immunocompetence.

The current randomized controlled trial prospectively tested the effects of DCC for 30-45 seconds followed by 1 cord milking with the aim of confirming our prior work and providing long-term follow-up. Our a priori hypotheses were that DCC would reduce the incidence of IVH, LOS, and result in better motor function at 18-22 months.

Study Type

Interventional

Enrollment (Actual)

72

Phase

  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Rhode Island
      • Providence, Rhode Island, United States, 02905
        • Women & Infants Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • Women pregnant with gestation 24 to 31.6 weeks of singleton pregnancy by obstetrical evaluation
  • Obstetrician's approval of enrollment into study
  • Parental consent
  • Any mode of birth will be included

Exclusion Criteria:

  • Obstetrician's refusal to enroll infants
  • Parental refusal for consent
  • Prenatally-diagnosed major congenital anomalies [or multiple gestations]
  • Intent to withhold or withdraw care
  • Severe or multiple maternal illnesses, frank vaginal bleeding, placenta abruption or previa
  • Mothers who are institutionalized or psychotic

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Single Group Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: 1-Immediate Cord Clamping
infants received the routine care of immediate clamping of the umbilical cord
Experimental: 2-Delayed Cord Clamping
after birth, cord clamping was delayed 30 to 45 seconds while infant was held lower than the level of the placenta.
Procedure: delayed cord clamping
cord clamping was delayed for 30 to 45 seconds and infant was held lower than the level of the placenta
Other Names:
  • cord clamping time

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
VLBW infants in the delayed clamped group will have less chronic lung disease at 36 weeks postmenstrual age compared to VLBW infants in the immediate cord clamped grouped
Time Frame: 36 wks postmenstrual age
36 wks postmenstrual age
VLBW infants in the delayed clamped group will have fewer incidences of suspected necrotizing enterocolitis during the NICU stay when compared with VLBW infants in the immediate cord clamped group
Time Frame: Hospital discharge
Hospital discharge
VLBW infants in the delayed clamped group will have better motor function by 6 to corrected age when compared with VLBW infants in the immediate cord clamped group
Time Frame: 7 months corrected age
7 months corrected age

Secondary Outcome Measures

Outcome Measure
Time Frame
Infants in the delayed cord clamping group will have less IVH than infants in the immediate clamping group
Time Frame: NICU stay
NICU stay
Infants in the delayed clamping group will hvae less late onset sepsis than infants in the immediate clamping group.
Time Frame: NICU Stay
NICU Stay

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Rhode Island

Collaborators

National Institute of Nursing Research (NINR)
Thrasher Research Fund

Investigators

  • Principal Investigator: Judith S Mercer, PhD, CNM, University of Rhode Island

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

August 1, 2003

Primary Completion (Actual)

November 1, 2005

Study Completion (Actual)

December 1, 2006

Study Registration Dates

First Submitted

February 10, 2009

First Submitted That Met QC Criteria

February 10, 2009

First Posted (Estimate)

February 11, 2009

Study Record Updates

Last Update Posted (Estimate)

November 30, 2015

Last Update Submitted That Met QC Criteria

November 27, 2015

Last Verified

November 1, 2015

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Mercer-K23-03
  • R01NR010015-01A2 (U.S. NIH Grant/Contract)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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