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A Single-Center Experience of Implementing Delayed Cord Clamping in Babies Born at Less Than 33 Weeks' Gestational Age

Aziz, Khalid MA, FRCPC, FRCPCH; Chinnery, Heather RN, MN; Lacaze-Masmonteil, Thierry MD, PhD, FRCPC

Section Editor(s): Dowling, Donna

doi: 10.1097/ANC.0b013e3182761246
Original Research

Objective: To describe the implementation and outcomes of delayed cord clamping (DCC) in preterm babies.

Study Design: Following staff orientation, a policy of DCC for 45 seconds was instituted for all eligible babies born between 28 and 32 weeks' gestational age, and later to all those younger than 33 weeks.

Results: Of 480 babies, 349 (73%) were eligible for DCC. Of these, 236 (68%) received DCC. Monthly compliance rates to DCC protocol in eligible babies ranged from 18% to 93%. There was no significant difference in demographic measures or rates of delivery room ventilation between eligible babies who did or did not receive DCC. Delayed cord clamping was associated with less hypothermia, higher initial hemoglobin levels, and less necrotizing enterocolitis, with a trend toward lower 1-minute Apgar scores and less blood pressure support.

Conclusions: The DCC protocol is feasible in preterm babies with reinforcement and education. It appears practical, safe, and applicable, and has minimal impact on immediate neonatal transition, with possible early neonatal benefits.

University of Alberta (Mr Aziz) and Stollery Children's Hospital, Neonatal Intensive Care Program (Mr Chinnery), Edmonton, Alberta, Canada; and Children Hospital of Eastern Ontario, Ottawa, Canada (Dr Lacaze-Masmonteil).

Correspondence: Khalid Aziz, MA, FRCPC, FRCPCH, Department of Pediatrics, University of Alberta, Royal Alexandra Hospital Neonatal Intensive Care Unit, DTC 5027, Royal Alexandra Hospital, 10240 Kingsway, Edmonton, AB T5H 3V9, Canada (khalid.aziz@ualberta.ca).

The authors thank Royal Alexandra Hospital Resuscitation Committee and Resuscitation-Stabilization-Triage Team members for practice change and data entry; Barbara Kamstra, neonatal research nurse, for data abstraction; Xinzhe Shi, MPH, MMSc, for statistical analysis; and Dr Paul Byrne for proofreading.

The authors declare no conflict of interest.

© 2012 National Association of Neonatal Nurses