Evidence map›Paper›PMID 23867960›Full record

Trial reportJournal of perinatology : official journal of the California Perinatal Association2013

The effects of umbilical cord milking in extremely preterm infants: a randomized controlled trial.

M I March, M R Hacker, A W Parson, A M Modest, M de Veciana

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of perinatology : official journal of the California Perinatal Association, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 11 pooled it
9.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 11 syntheses or guidelines pooled it, 115 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Antenatal and perinatal factors influencing neonatal blood pressure: a systematic review.Journal of perinatology : official journal of the California Perinatal Association · 2021
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
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  9. Pooled it
  10. Pooled it
  11. Singapore Neonatal Resuscitation Guidelines 2016.Singapore medical journal · 2017
    Guideline
  12. Trial
  13. Trial
  14. Trial
  15. Timing of umbilical cord clamping among infants born at 22 through 27 weeks' gestation.Journal of perinatology : official journal of the California Perinatal Association · 2016
    Trial
  16. Comparison of three types of intervention to enhance placental redistribution in term newborns: randomized control trial.Journal of perinatology : official journal of the California Perinatal Association · 2015
    Trial
  17. Trial
  18. Trial
  19. Article
  20. Umbilical cord milking-benefits and risks.Frontiers in pediatrics · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

M I March1] Division of Maternal-Fetal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA [2] Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA [3] Harvard Medical School, Boston, MA, USA.
M R Hacker
A W Parson
A M Modest
M de Veciana
Beth Israel Deaconess Medical Center · USEastern Virginia Medical School · USHampton Roads Sanitation District · USHarvard University · US

Funding

Harvard Clinical and Translational Science Center (UL1)UL1TR000170 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2012 to 2013
$31.4M
NCATS NIH HHS 8UL1TR000170-05NCATS NIH HHS UL1 TR000170
6 · The paper itself

Abstract

objectiveDelayed cord clamping has been shown to decrease the need for transfusion in preterm neonates, but may delay resuscitation. The aim of this study was to determine whether umbilical cord milking compared with immediate cord clamping in extremely preterm deliveries reduces the need for neonatal red blood cell transfusion. STUDY

designWomen admitted to a tertiary care center and expected to deliver between 24 to 28 completed weeks of gestation were randomized to cord milking before clamping or immediate cord clamping. The primary outcome was the risk of neonatal transfusion, reported as risk ratio (RR) and 95% confidence interval (CI).

resultOf 113 women who were enrolled and randomized, 56 were assigned to cord milking with 36 remaining eligible and completing the study and 57 were assigned to the control group with 39 remaining eligible and completing the study. Albeit not statistically significant, neonates in the cord milking group were less likely to require transfusion compared with those in the control group (RR: 0.86; 95% CI: 0.73 to 1.0). Neonates whose cords were milked had higher hematocrits at birth (P=0.004) and were less likely to develop an intraventricular hemorrhage (P=0.0195).

conclusionMilking the umbilical cord of a preterm neonate is an easy intervention with the potential to improve perinatal outcomes. Our results suggest that milking of the cord increases the neonate's initial hematocrit and may lessen the need for transfusion in the neonatal period. The observed reduction in the incidence of intraventricular hemorrhage may have important long-term implications that warrant further study.

Indexed as

Infant, Extremely PrematurePostnatal CarePregnancy OutcomeUmbilical CordAdultBlood TransfusionCerebral HemorrhageConstrictionFemaleHematocritHumansIncidenceInfant, NewbornPilot ProjectsPlacental CirculationPregnancy

Identifiers

PMID23867960
PMCPMC3916936
OpenAlexW1998002869

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.