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A Randomized Controlled Trial to Evaluate the Role of Brief Delay in Cord Clamping in Preterm Neonates (34–36 weeks) on Short-term Neurobehavioural Outcome

Aim
To study the effect of brief delay in cord clamping on short-term neurobehavioural outcome of preterm neonates.


Methods
All preterm neonates born between 34-36 weeks and 6 days were included and randomized into either a control or intervention group. In the control group, clamping was done within 20 s after delivery, and this was termed as immediate cord clamping (ICC). In the intervention group, delayed cord clamping (DCC) took place between 30 and 60 s. A total of 120 preterm neonates were enrolled. The primary outcome studied was short-term neurobehavioural outcome at 37 weeks after conceptional age using the Neurobehavioral Assessment of Preterm Infants (NAPI) score as the outcome measure.


Results
NAPI scores at 37 weeks of corrected gestational age revealed a mean (95% confidence interval) score of motor development and vigour of 64.21±27.31 (57.27 - 71.14) vs. 76.69±25.29 (70.04-83.34), p = 0.01; and alertness and orientation of 29.31±12.78 (26.06-32.55) vs. 42.77±15.75 (38.63-46.91), p = 0.00 across the ICC vs. DCC groups, respectively.


Conclusion
A brief delay of 30-60 s in cord clamping is beneficial in improving neurobehavioural outcome of late preterm infants.