Delayed Cord Clamping in Very Low Birth Weight Infants
Delayed Cord Clamping in Very Low Birth Weight Infants
The purpose of this study is to determine if there is a difference in neonatal outcomes with
 delayed umbilical cord clamping at 30 versus 60 seconds. Our primary outcome will be
 intraventricular hemorrhage (IVH) (bleeding in the brain) in these infants.
Immediately following delivery, up to 40% of the total blood volume available to the infant
 is in the placenta. Over a period of 30 seconds to 3 minutes, a significant portion of this
 blood is transferred to the infant through the umbilical cord. Delayed cord clamping
 following delivery facilitates this transfer of blood.

 Preterm infants are very susceptible to the effects of anemia and hypovolemia. A recent
 meta-analysis showed that a brief delay in umbilical cord clamping (30-60 seconds) decreases
 the risk of anemia, blood transfusion, intraventricular hemorrhage, necrotizing
 enterocolitis, and the need for blood pressure support after delivery. The same meta-analysis
 showed no impact on Apgar scores or hypothermia due to a brief delay in resuscitation efforts
 to allow delayed cord clamping.

 Preterm infants are at significant risk for IVH and as high as 20% of very low birth weight
 infants will have it. IVH is an important cause of brain injury in these infants. In our
 study, we would like to determine the optimal timing of delayed cord clamping in order to
 prevent IVH in these infants.
Inclusion Criteria:

 -  Pregnant women who are expected to deliver a very low birth weight infant

 -  Neonates born weighing >= 500g and <1500 grams

 -  Mother 18 years of age or older

 -  English speaking mother

 Exclusion Criteria:

 -  Placental abruption

 -  Vasa previa

 -  Fetal hydrops or other signs of fetal volume overload

 -  Other major fetal anomalies

 -  Placenta Accreta

 -  Mother < 18 years of age

 -  Non-English speaking mother

 -  Infants >= 1500g (3.3 lbs) or <500g