Evidence map›Paper›PMID 33497396›Full record

Trial reportPloS one2021

Effect of umbilical cord milking versus delayed cord clamping on preterm neonates in Kenya: A randomized controlled trial.

Mandeep Sura, Alfred Osoti, Onesmus Gachuno, Rachel Musoke, Frank Kagema, George Gwako, Diana Ondieki, Patrick M Ndavi, Omondi Ogutu

Open access · goldAbstract readComparative StudyPragmatic Clinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 3 pooled it
1.8field-weighted citation impact, top 15% 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

10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 15 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Article
  6. Article
  7. Article
  8. Umbilical cord milking-benefits and risks.Frontiers in pediatrics · 2023
    Review
  9. Review
  10. Article
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

9 authors at 2 institutions in 2 countries.

Mandeep SuraDepartment of Obstetrics and Gynecology, College of Health Sciences, University of Nairobi, Nairobi, Kenya.ORCID 0000-0003-3616-5811
Alfred OsotiDepartment of Obstetrics and Gynecology, College of Health Sciences, University of Nairobi, Nairobi, Kenya.
Onesmus GachunoDepartment of Obstetrics and Gynecology, College of Health Sciences, University of Nairobi, Nairobi, Kenya.
Rachel MusokeDepartment of Pediatrics, College of Health Sciences, University of Nairobi, Nairobi, Kenya.
Frank KagemaDepartment of Obstetrics and Gynecology, Kenyatta National Hospital, Nairobi, Kenya.
George GwakoDepartment of Obstetrics and Gynecology, College of Health Sciences, University of Nairobi, Nairobi, Kenya.
Diana OndiekiDepartment of Obstetrics and Gynecology, College of Health Sciences, University of Nairobi, Nairobi, Kenya.
Patrick M NdaviDepartment of Obstetrics and Gynecology, College of Health Sciences, University of Nairobi, Nairobi, Kenya.
Omondi OgutuDepartment of Obstetrics and Gynecology, College of Health Sciences, University of Nairobi, Nairobi, Kenya.
University of Nairobi · KEKenyatta National Hospital · KE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDelayed cord clamping (DCC) is a placental to new-born transfusion strategy recommended by obstetric and gynaecological societies. Though not widely adopted, umbilical cord milking (UCM) may achieve faster transfusion when DCC cannot be performed such as when a neonate requires resuscitation.

methodsPragmatic, two-arm, randomized clinical trial in which consenting women in spontaneous labour or provider-initiated delivery at 28 to less than 37 weeks at Kenyatta National Hospital in Nairobi, Kenya, were enrolled. At delivery, stable preterm infants were randomized to UCM (4 times) or DCC (60 seconds). Neonatal samples were collected for analysis at 24 hours after delivery. Maternal primary PPH (within 24 hours) and neonatal jaundice (within 1 week) were evaluated clinically. The primary outcome was the mean neonatal haemoglobin level at 24 hours after birth. Modified Intention to treat analysis was used for all outcomes. P-value was significant at p<0.05.

resultsBetween March 2018 to March 2019, 344 pregnant women underwent screening, and 280 eligible participants were randomized when delivery was imminent. The intervention was not performed on 19 ineligible neonates. Of the remaining 260 neonates, 133 underwent UCM while 128 underwent DCC. Maternal and neonatal baseline characteristics were similar. The mean neonatal haemoglobin (17.1 vs 17.5 grams per decilitre, p = 0.191), haematocrit (49.6% vs 50.3%, p = 0.362), anaemia (9.8% vs 11.7%, p = 0.627), maternal PPH (2.3% vs 3.1%, p = 0.719) were similar between UCM and DCC respectfully. However, neonatal polycythaemia (2.3% vs 8.6%, p = 0.024) and neonatal jaundice (6.8% vs 15.6%, p = 0.024) were statistically significantly lower in UCM compared to DCC.

conclusionUCM compared to DCC for preterm neonates resulted in similar outcomes for neonatal haemoglobin, haematocrit, anaemia and maternal primary PPH and a lower proportion of neonatal polycythaemia and clinical jaundice. UCM offers a comparable method of placental transfusion compared to DCC and may be considered as an alternative to DCC in preterm neonates at 28 to <37 weeks' gestation.

Indexed as

Labor, ObstetricParturitionPlacentaUmbilical CordFemaleHumansInfant, NewbornKenyaMalePregnancy

Identifiers

PMID33497396
PMCPMC7837492
OpenAlexW3125686738

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.