Umbilical cord blood collection at birth reduces early iatrogenic blood loss in preterm infants with birth weights <1,500 g

TL;DR

Collecting umbilical cord blood at birth helps reduce early blood loss in very low birth weight preterm infants, lowering the need for blood draws and transfusions.

Contribution

This study demonstrates that umbilical cord blood collection reduces early iatrogenic blood loss in very low birth weight preterm infants.

Findings

Preterm infants with birth weight <1,250 g who had UCB collected had lower hemoglobin levels and less blood drawn in the first week.

UCB collection was associated with a higher rate of non-transfusion within 7 days in very low birth weight infants.

Blood drawn volumes were significantly lower in the UCB group for both birth weight categories.

Abstract

Frequent blood collection leads to anemia and increased transfusion needs. Umbilical cord blood (UCB) collection has been suggested to reduce the need for subsequent blood draws, but its effectiveness, especially in very low birth weight infants (VLBWI), remains insufficiently explored.

This retrospective study was approved by the Ethics Committee of Xiangya Third Hospital, Central South University (No. 23673), which granted a waiver of informed consent in accordance with national regulations and institutional guidelines, stratifying infants into two groups based on whether UCB was collected at birth: the UCB collection (UCB, 68 infants) group and the non-umbilical cord blood collection (NUCB, 70 infants) group. These cohorts were further analyzed according to birth weight (BW), with 64 infants with BW ≥1,250 g (UCB=21, NUCB=43) and 74 infants with BW < 1,250 g (UCB=47, NUCB=27). Clinical data were then collected and analyzed.

Among preterm infants with BW < 1,250 g, the occurrence of hemoglobin (Hb) < 120 g/L within the first week after birth, the volume of blood drawn within the first 24 h and the first three days after birth were significantly lower in the UCB group than in the NUCB group (P < 0.05); the rate of non-transfusion within 7 days after birth was higher in the UCB group than that in the NUCB group (P < 0.05). In preterm infants with BW ≥1,250 g, the volume of blood drawn within 24 h and within the first three days after birth was significantly lower in the UCB group than in the NUCB group (P < 0.05).

UCB can effectively reduce the volume of blood drawn from VLBWI in the early postnatal period, and help protect those preterm infants from adverse stimuli.

Chinese Clinical Trial Registry, ChiCTR2500113741.