Health outcomes of umbilical cord clamping techniques in preterm neonates: meta-analysis

TL;DR

This study examines how timing and milking of umbilical cord clamping affects blood parameters in preterm babies.

Contribution

It provides new evidence that late cord clamping and cord milking may help prevent anemia in preterm neonates.

Findings

Late cord clamping and cord milking increase hematocrit and ferritin levels in preterm neonates.

No significant differences in hemoglobin or bilirubin levels were observed between groups.

Adverse health outcomes were not significantly affected by cord clamping techniques.

Abstract

The aim of this study was to determine the effect of umbilical cord clamping time and milking on blood parameters in preterm neonates.

A literature search was conducted between July and September 2024 in four databases. The search was performed using MeSH-based keywords.

In this study, the results of 14 studies covering a total of 1,609 preterm neonates were analyzed. Follow-up after intervention showed no statistically significant difference in hemoglobin (standardized mean difference=0.22, 95%CI 0.04–0.48, Z=1.65, p=0.10) and bilirubin (standardized mean difference=0.22, 95%CI 0.30–0.74, Z=0.82, p=0.41) between the groups. There was a statistically significant difference in ferritin (standardized mean difference=0.73, 95%CI 0.30–1.15, Z=3.37, p=0.00008) and hematocrit (standardized mean difference=0.30, 95%CI 0.05–0.54, Z=2.41, p=0.02) values, and the effect size was positive. According to the subgroup analysis of the combined results of the studies, it was seen that there was no statistically significant difference in the adverse health outcomes in preterms (OR 0.92, 95%CI 0.74–1.15, Z=0.72, p=0.47).

From the analysis, it can be observed that late cord clamping and cord milking can prevent premature anemia by increasing hematocrit and ferritin formation in preterm newborns.

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