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ARTICLES: Judith S. Mercer, Betty R. Vohr, Margaret M. McGrath, James F. Padbury, Michael Wallach, and William Oh Delayed Cord Clamping in Very Preterm Infants Reduces the Incidence of Intraventricular Hemorrhage and Late-Onset Sepsis: A Randomized, Controlled Trial Pediatrics 2006; 117: 1235-1242 [Abstract] [Full text] [PDF]

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Delayed Cord Clamping: How Confident Can We Be Of The Benefits

Steve Piecuch, MD, MPH   (16 April 2006)

Cautious in adopting delayed cord clamping

Ramesha Papanna   (6 December 2006)

Delayed Cord Clamping: How Confident Can We Be Of The Benefits 16 April 2006
Steve Piecuch, MD, MPH, Neonatologist Kings County Hospital Center, Brooklyn, NY Send letter to journal: Re: Delayed Cord Clamping: How Confident Can We Be Of The Benefits stevepiecuch{at}aol.com Steve Piecuch, MD, MPH	Mercer and colleagues found a statistically significant decrease in late onset infection and intraventricular hemorrhage (IVH) in a group of premature infants with delayed cord clamping compared with a group with immediate cord clamping. They point out that their results are consistent with a recent Cochrane Review and propose a reasonable explanation for the differences that they observed. However, it is interesting to note that the level of significance for both comparisons (p = 0.03) was relatively small. While the data was grouped and analyzed appropriately, the study did involve multiple comparisons and I would question how confident one can be that the differences observed here were not actually due to chance alone. Also, with respect to the observed differences in IVH rates, almost all of the IVH that occurred was Grade 1 or Grade 2, which is clearly a reflection of the excellent obstetrical and neonatal care provided to these infants. While a larger study might have demonstrated a statistically significant difference in Grade 3 and Grade 4 IVH, in this study no statistically significant difference in the rate of severe IVH between the groups was demonstrated. Conflict of Interest: None declared
Cautious in adopting delayed cord clamping 6 December 2006
Ramesha Papanna, Resident, Obstetrics and Gynecology Rochester General Hospital Send letter to journal: Re: Cautious in adopting delayed cord clamping Ramesha.Papanna{at}viahealth.org Ramesha Papanna	Mercer JS and colleagues have done a well designed study to demonstrate effects of delayed cord clamping in very preterm infants. The sample size was too small to demonstrate the difference in the primary outcome BPD, but the positive trends for DCC merits further studies. Given the lack of adverse events in the DCC group, some might consider adopting this practice until definitive studies are completed. Conflict of Interest: None declared

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