Risk of neurological delay is not increased by umbilical cord lactation in weak infants

Press release

Monday July 1, 2020

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An NIH-funded study shows that a blood-sparing alternative is a safer option than the current standard.

A treatment that moves blood from the umbilical cord into the body of newborns with weak breathing and limbo, also called "non-vigorous," does not appear to increase the risk of disorders, according to a study funded by the National Institutes of Health. neurodevelopmental. Nearly 1,000 full-term or full-term babies were included in the study. The researchers compared milking the umbilical cord to clamping the cord and cutting it early, so that resuscitation can begin as quickly as possible.

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The researchers conducted this study to address concerns raised in a previous Study It is possible that umbilical milking of extremely premature babies could result in brain damage. According to the current results, umbilical milking does not increase the risk of brain damage in full-term infants. This proves that umbilical milking may be a safer alternative to waiting for cord blood to circulate naturally through the body.

Infants who are not vigorous can suffer from cerebral palsy, stroke and low oxygen levels. For non-vigorous babies, it is standard practice to clamp the cord and begin resuscitation immediately. However, in vigorous full-term infants, immediate clamping and cutting of the umbilical cord is recommended. Current recommendation It is recommended to delay tightening the cord and cutting it for 30 to 60 seconds. Blood from the cord can then enter the baby's system. Infants who receive delayed cord clamping are more likely to have higher hemoglobin and iron levels than those who receive immediate clamping.

In the current study, investigators evaluated children who had previously participated in similar research. To study Screening tests are done to determine neurocognitive growth before children reach age two. In the previous study, treating providers treated the 20 centimeter cord for 2 seconds and repeated the procedure 3 times.

The Ages and Stages Questionnaire 3 was used as a screening tool to determine potential developmental delays among the 964 infants who survived the study. In the umbilical cord milking group, 502 children scored between 225 and 280. The 469 children in the early cord clamping group also had scores between 230 and 280. A total of 927 children survived and were assessed using a screening tool to determine risk for autism spectrum disorders (ASD) in toddlers. This was known as the Modified Toddler Autism Checklists Revised with Follow-up. The proportion of toddlers at medium to high risk for ASD was the same in both groups. 45 of 486 children in the cord-treating group and 37 of 441 children in the cord-clamping group early achieved this result.

A previous study showed that umbilical cord-fed infants were more likely than non-vigorous babies who received early cord cutting and clamping to need cardiac and respiratory support, have low oxygen or blood, to have lower hemoglobin levels. , as well as feeling a reduction in cerebral and/or blood oxygenation. Follow up Study Researchers found that, compared to infants who were cut and clamped early, non-vigorous babies who received cord milking experienced increased blood pumping from their hearts and more blood flowing to their lungs. . and the brain.

They concluded that umbilical cord milking, combined with the benefits observed in previous studies, is a reasonable intervention that does not appear to increase the risk of neurodevelopmental delay in term or short-term babies who are not vigorous. .

Anup Katheria MD and colleagues from the United States of America, Canada and Poland conducted the study. The study appears in JAMA Network Open. Funding was provided by the NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development

What is the best way to contact us? Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentNICHD is a leader in research and education to better understand the human condition, improve reproductive health, and enhance the lives and capabilities of children and adolescents. Visit the website for more information. https://www.nichd.nih.gov.

The National Institutes of Health: NIH is the medical research agency of the United States Department of Health and Human Services. It includes 27 institutes and centers. The NIH, the nation's medical research agency, is a component of the U.S. Department of Health and Human Services. It is responsible for conducting basic, translational and clinical medical research and studying causes, treatments and cures. Visit NIH for more information about its programs and services. www.nih.gov.

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