Umbilical cord milking versus delayed cord clamping in infants 28 to 32 weeks: A randomized trial

Our randomised controlled trial of umbilical cord milking versus delayed cord clamping among preterm infants born between 28 and 32 weeks' gestation found no difference in the rates of severe intraventricular hemorrhage or death.


Keelin O'Donoghue

Journal Name
Journal Article
Full Citation

Katheria A, Szychowski J, Carlo WA, Subramaniam A, Reister F, Essers J, Vora F, Martin C, Schmölzer GM, Law B, Dempsey E, O’Donoghue K, Kaempf J, Tomlinson M, Fulford K, Folsom B, Karam S, Morris R, Yanowitz T, Beck S, Clark E, DuPont T, Biniwale M, Ramanathan R, Bhat S, Hoffman M, Chouthai N, Bany-Mohammed F, Mydam J, Narendran V, Wertheimer F, Gollin Y, Vaucher Y, Arnell K, Varner M, Cutter G, Wilson N, Rich W, Finer N. Umbilical cord milking versus delayed cord clamping in infants 28 to 32 weeks: A randomized trial. Pediatrics. 2023;e2023063113. 10.1542/peds.2023-063113.

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We aimed to determine whether the risk of bleeding in the brain and/or risk of death as a result of being born preterm (between 28 and 32 weeks of pregnancy) was different in infants who had umbilical cord milking (UCM) or delayed cord clamping (DCC) at birth. A randomised controlled trial comparing UCM versus DCC in preterm infants born 28 to 32 weeks was performed between June 2017 through September 2022 from 19 university and private medical centers in 4 countries. The primary outcome was a severe brain bleed or death evaluated. Among 1019 infants (UCM n = 511 and DCC n = 508), all completed the trial from birth through initial hospitalisation (mean gestational age 31 weeks, 44% female). For the primary outcome, 7 of 511 (1.4%) infants randomised to UCM developed a severe brain bleed or bleeds, or died compared to 7 of 508 (1.4%) infants randomized to DCC. Overall, there was no difference in these outcomes regardless of how the cord was managed at birth. Therefore, UCM may be a safe alternative to DCC in preterm infants born at 28 to 32 weeks who require resuscitation at birth.

Pregnancy Loss Research Group

Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, Fifth Floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland,