Maternal bleeding complications and neonatal outcomes following

AbstractObjectiveDetermine effect of at least 60 s delayed cord clamping (DCC) on postpartum hemorrhage and maternal estimated blood loss (EBL) in very low birth weight (VLBW) cesarean deliveries when compared to early cord clamping (ECC).Study designRetrospective study of VLBW infants at birth. Maternal pre- and post-operative hemoglobin, EBL, and neonatal outcomes were collected.ResultsIn total, 620 VLBW infants (DCC = 166, ECC = 454) born to 545 mothers (DCC = 155, ECC = 390) were included. Maternal PPH between DCC was 8% versus ECC was 10% p = 0.52. There were no differences in estimated blood loss or rate of maternal blood transfusion between groups. The post-operative hemoglobin was lower in infants receiving ECC compared to DCC (10.4 [9.4–11.5] versus 10.8 [10.1–11.9] g/dl, p = 0.01). In comparing pre-operative to post-operative hemoglobin there was no difference between DCC and ECC (−1.2 [−2.0 to −0.3] versus −1.2 [−2.1 to −0.6] g/dl, p = 0.46).ConclusionDCC of at least 60 s did not increase maternal bleeding complications during VLBW cesarean delivery. To our knowledge, this retrospective study is the largest sample size to date of preterm cesarean deliveries to support maternal safety regarding bleeding complications after delayed cord clamping. This is a preview of subscription content, access via your institution Access options Subscribe to JournalGet full journal access for 1 year$119.00only $9.92 per issueAll prices are NET prices. VAT will be added later in the checkout.Tax calculation will be finalised during checkout.Buy articleGet time limited or full article access on ReadCube.$32.00All prices are NET prices. 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Resuscitation. 2020;147:26–33.Article  PubMed  Google Scholar  Download referencesAcknowledgementsACK was supported by the Cushman Foundation, the Chuck and Ernestina Kreutzkamp Foundation and the Stephen and Lynne Doyle Foundation. We thank the following individuals for their expertise and assistance throughout all aspects of our study: Alexis Rosete, Kaitlyn Fitzgerald, Ana Morales, Elise Mischke, Lukas Linares, Marcie Portillo, and Kathy Arnell.Author informationAuthors and AffiliationsNeonatal Research Institute at Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA, USACatherine Salcido, Soha A. Shahidi, Debra M. Poeltler & Anup C. KatheriaSpecialty Obstetrics, San Diego, CA, USAYvonne GollinSharp Rees-Stealy Obstetrics, San Diego, CA, USALisa A. JohnstonContributionsAll authors contributed to the conceptualization, design, and review of the work. CS substantially contributed to data curation, drafting, and writing manuscript. SAS contributed to data curation and initial manuscript. DMP contributed to data analysis and manuscript revision. ACK co-wrote manuscript and gave final approval of this version.Corresponding authorCorrespondence to Anup C. Katheria.Ethics declarations Competing interests The authors declare no competing interests. Additional informationPublisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.Rights and permissionsSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.Reprints and PermissionsAbout this articleCite this articleSalcido, C., Shahidi, S.A., Poeltler, D.M. et al. Maternal bleeding complications and neonatal outcomes following early versus delayed umbilical cord clamping in cesarean deliveries for very low birthweight infants. J Perinatol (2022). https://doi.org/10.1038/s41372-022-01558-4Download citationReceived: 25 April 2022Revised: 27 October 2022Accepted: 01 November 2022Published: 10 November 2022DOI: https://doi.org/10.1038/s41372-022-01558-4
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