- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT07699666
Delayed Versus Immediate Cord Clamping in Preterm Birth (PREM-CORD)
Early Neonatal Outcomes After Delayed Versus Immediate Cord Clamping in Preterm Birth: A Comparative Study From A Tunisian Tertiary Maternity Center
The goal of this study is to evaluate whether delayed cord clamping improves early neonatal outcomes compared with immediate clamping in preterm birth.
Preterm infants are at higher risk of neonatal complications, and the timing of cord clamping may influence placental transfusion and neonatal adaptation after birth. Delayed cord clamping may increase blood volume, improve iron stores, and reduce some neonatal morbidities, while immediate cord clamping is still commonly practiced in many settings.
In this study, preterm newborns are assigned to either delayed or immediate cord clamping according to a predefined protocol. Early neonatal outcomes, including respiratory status, need for resuscitation, hemoglobin levels, and early morbidity and mortality, will be assessed.
The study is conducted in a tertiary maternity center in Tunisia.
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Studientyp
Einschreibung (Geschätzt)
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
- Name: Mohammed Amine MA Hannachi, Assistant professor
- Telefonnummer: +21699696332
- E-Mail: mohammedamine.hannachi@fmt.utm.tn
Studieren Sie die Kontaktsicherung
- Name: Khaled Neji, Professor
- Telefonnummer: +21651352742
- E-Mail: DRKHALEDNEJI21@GMAIL.COM
Studienorte
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Tunis Governorate
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Tunis, Tunis Governorate, Tunesien, 1007
- Rekrutierung
- Maternity and neonatology center of Tunis
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Kontakt:
- E-Mail: medaminehannachi3@gmail.com
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Kontakt:
- Mohammed Amine Hannachi
- Telefonnummer: 99696332
- E-Mail: medaminehannachi3@gmail.com
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Hauptermittler:
- Mohammed Amine MA Hannachi, Assistant Professor
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
- Kind
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Inclusion Criteria:
- Preterm neonates born at gestational age between 32 and 37 weeks
- Live-born infants delivered in the study center
- Singleton pregnancies
- Parental consent obtained when applicable according to institutional ethical requirements
Exclusion Criteria:
- Major congenital malformations or chromosomal abnormalities
- Need for immediate advanced resuscitation at birth
- Severe fetal distress requiring emergency obstetric intervention incompatible with protocol allocation
- Placental conditions contraindicating delayed cord clamping (e.g., placental abruption with maternal instability, placenta previa bleeding, Placenta accreta spectrum)
- Intra Uterin Growth Restriction with abnormal umbilical artery Doppler velocimetry
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Nicht randomisiert
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
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Experimental: Delayed Umbilical Cord Clamping
Delayed umbilical cord clamping is performed in preterm infants according to the study protocol.
The umbilical cord is clamped after a predefined delay following birth (at least 30 seconds), allowing continued placental transfusion to the neonate before cord clamping.
The intervention is applied immediately after delivery while ensuring neonatal stabilization according to standard clinical practice.
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Delayed umbilical cord clamping is performed in preterm infants by delaying umbilical cord clamping for a predefined duration after birth (at least 30 seconds), allowing continued placental transfusion prior to neonatal separation from the placenta.
The procedure is applied immediately after delivery, with neonatal stabilization provided according to standard clinical practice.
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Experimental: Immediate Umbilical Cord Clamping
Immediate umbilical cord clamping is performed in preterm infants according to standard practice.
The umbilical cord is clamped shortly after birth without intentional delay, typically within seconds of delivery, before significant placental transfusion occurs.
Neonatal care is provided immediately after clamping according to routine clinical protocols.
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Immediate umbilical cord clamping is performed in preterm infants by clamping the umbilical cord shortly after birth without intentional delay, typically within seconds following delivery, before significant placental transfusion occurs.
Neonatal care is initiated immediately after clamping according to standard practice.
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Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
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Neonatal Mortality
Zeitfenster: Within 7 days of birth (or until hospital discharge, whichever occurs first)
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Death of the neonate occurring within the first 7 days of life or during initial hospitalization in preterm infants allocated to delayed versus immediate umbilical cord clamping.
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Within 7 days of birth (or until hospital discharge, whichever occurs first)
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Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
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Neonatal Anemia
Zeitfenster: Within 24-48 hours of birth and if possible 3 to 4 months after birth
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Hemoglobin concentration below the predefined threshold for gestational age or need for red blood cell transfusion during the early neonatal period.
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Within 24-48 hours of birth and if possible 3 to 4 months after birth
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Necrotizing Enterocolitis (NEC)
Zeitfenster: From Birth up to 28 days after birth
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Incidence of necrotizing enterocolitis stage ≥ II (Bell's classification) in preterm infants.
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From Birth up to 28 days after birth
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Intraventricular Hemorrhage (IVH)
Zeitfenster: Within first 7 days of life
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Presence of intraventricular hemorrhage diagnosed by cranial ultrasound, classified according to standard grading system (Papile classification).
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Within first 7 days of life
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Length of Neonatal Intensive Care Unit (NICU) Stay
Zeitfenster: From Birth up to 28 days after birth
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Duration of admission in neonatal intensive care unit measured in days.
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From Birth up to 28 days after birth
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Mitarbeiter und Ermittler
Sponsor
Publikationen und hilfreiche Links
Allgemeine Veröffentlichungen
- Fogarty M, Osborn DA, Askie L, Seidler AL, Hunter K, Lui K, Simes J, Tarnow-Mordi W. Delayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-analysis. Am J Obstet Gynecol. 2018 Jan;218(1):1-18. doi: 10.1016/j.ajog.2017.10.231. Epub 2017 Oct 30.
- Madar J, Roehr CC, Ainsworth S, Ersdal H, Morley C, Rudiger M, Skare C, Szczapa T, Te Pas A, Trevisanuto D, Urlesberger B, Wilkinson D, Wyllie JP. European Resuscitation Council Guidelines 2021: Newborn resuscitation and support of transition of infants at birth. Resuscitation. 2021 Apr;161:291-326. doi: 10.1016/j.resuscitation.2021.02.014. Epub 2021 Mar 24.
- McDonald SD, Narvey M, Ehman W, Jain V, Cassell K. Guideline No. 424: Umbilical Cord Management in Preterm and Term Infants. J Obstet Gynaecol Can. 2022 Mar;44(3):313-322.e1. doi: 10.1016/j.jogc.2022.01.007.
- Guideline: Delayed Umbilical Cord Clamping for Improved Maternal and Infant Health and Nutrition Outcomes. Geneva: World Health Organization; 2014. Available from http://www.ncbi.nlm.nih.gov/books/NBK310511/
- Ghirardello S, Di Tommaso M, Fiocchi S, Locatelli A, Perrone B, Pratesi S, Saracco P. Italian Recommendations for Placental Transfusion Strategies. Front Pediatr. 2018 Dec 3;6:372. doi: 10.3389/fped.2018.00372. eCollection 2018.
- Kc A, Malqvist M, Rana N, Ranneberg LJ, Andersson O. Effect of timing of umbilical cord clamping on anaemia at 8 and 12 months and later neurodevelopment in late pre-term and term infants; a facility-based, randomized-controlled trial in Nepal. BMC Pediatr. 2016 Mar 10;16:35. doi: 10.1186/s12887-016-0576-z.
- ACOG Clinical Practice Update: An Update to Clinical Guidance for Delayed Umbilical Cord Clamping After Birth in Preterm Neonates. Obstet Gynecol. 2025 Jul 24;146(3):442-444. doi: 10.1097/AOG.0000000000006020.
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Primärer Abschluss (Geschätzt)
Studienabschluss (Geschätzt)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Urogenitale Erkrankungen
- Weibliche Urogenitalerkrankungen und Schwangerschaftskomplikationen
- Darmerkrankungen
- Geburtshilfe, Frühgeburt
- Geburtsbedingte Geburtskomplikationen
- Schwangerschaftskomplikationen
- Erkrankungen der Atemwege
- Erkrankungen des Verdauungssystems
- Magen-Darm-Erkrankungen
- Lungenkrankheit
- Atemstörungen
- Säugling, Frühchen, Krankheiten
- Säugling, Neugeborenes, Krankheiten
- Hämatologische Erkrankungen
- Gastroenteritis
- Anämie, Neugeborene
- Atemnotsyndrom, Neugeborenes
- Atemnotsyndrom
- Enterokolitis
- Angeborene, erbliche und neonatale Krankheiten und Anomalien
- Hämische und lymphatische Krankheiten
- Frühgeburt
- Anämie
- Enterokolitis, nekrotisierend
- Hyaline Membrankrankheit
- Fetofetale Transfusion
- Chirurgische Eingriffe, operativ
- Lieferung, Geburtshilfe
- Geburtshelfer chirurgische Verfahren
- Nabelschnurklemme
Andere Studien-ID-Nummern
- PREM-CORD
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
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