693 - Feasibility of physiological based cord clamping (PBCC) in very low birth weight infants and its impact on the following 72 hours

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 693
Publication Number: 693.444

Nina Hoeller, Medical University of Graz, Austria, Graz, Steiermark, Austria; Christina Helene. Wolfsberger, Medical University of Graz, Departement of Pediatrics and Adolescent Medicine, Division of Neonatology, Graz, Steiermark, Austria; Ernst P.. Prethaler, LKH Univrsitätsklinikum GRaz, Graz, Steiermark, Austria; Bernhard Schwaberger, Medical University of Graz, Graz, Steiermark, Austria; Gerhard Pichler, Medical University of Graz, Graz, Steiermark, Austria; Berndt Urlesberger, Medical University of Graz, Graz, Steiermark, Austria

Presenting Author(s)

Nina Hoeller, PhD (she/her/hers)

Fellow
Medical University of Graz, Austria
Graz, Steiermark, Austria

Background:

Physiological based cord clamping (PBCC) aims to establish lung aeration, adequate pulmonary blood flow and pulmonary blood gas exchange prior to cord clamping. Animal data and recent human studies in preterm neonates have shown improved cardiorespiratory stability during immediate transition using PBCC.

Objective:

The aim of the present study was to investigate the feasibility of PBCC in very low birth weight (VLBW) infants and its impact on the first 72 hours after birth.

Design/Methods:

In this retrospective study, VLBW infants delivered with PBCC were matched according to GA (± 1 week) and BW (± 100g) to infants with routine care (control-group) and a cord clamping time of 30-60sec. Infants of the PBCC-group were stabilized after birth with an intact cord using a mobile and heated resuscitation table (“Concord birth trolley”, Rotterdam, Netherlands). Routine monitoring parameters (heart rate [HR], arterial oxygen saturation [SpO₂], fraction of inspired oxygen [FiO₂], mean arterial blood pressure [MABP]) were recorded for 72 hours after birth and compared between the two groups.

Results:

54 VLBW infants (PBCC n=27; control n=27) were included. Mean GA of the PBCC-group was 27.4±1.9 weeks and 27.4±1.8 weeks in the control-group (p-value 0.869), mean BW was 912±288 g and 915±285 g (p-value 0.964), respectively. Cord clamping time was 191±78 sec in the PBCC-group. HR was lower in the PBCC-group during the first three days after birth, reaching significance during 11 hours. Other monitoring parameters did not reveal any significant differences between the two groups.

Conclusion(s):

PBCC was feasible in all infants and had no negative influence on cardiorespiratory stability in VLBW infants during the first 72 hours after birth, compared to routinely performed delayed cord clamping. The lower HR in the PBCC-group suggests higher blood volume following intact cord resuscitation.