Discussion
NEC, hypothermia, death, IVH, Placental transfusions
POSTPARTUM HEMORRHAGE, POLYCYTHEMIA
UCM combined with DCC; DCM-B or DCM-A should, theoretically, increase blood volume in preterm infants, compared to DCC alone. In our study, all three techniques showed no variations in hematocrit after intervention. Preterm infants in DCM-B (20%) and DCM-A (12.5%) groups requiring blood transfusion were fewer than those in DCC (25%) group but it was not significantly different. Our study had a lower rate of infants requiring transfusion compared to Jasani B et.al, a systematic review and network meta-analysis, which showed the rate of infants needing RBC transfusion in DCC group (38.3%) compared to immediate cord clamping (ICC) group (46.9%), and UCM (32.3%) compared to ICC group (46.9%) [Placental transfusions also reduced the incidence and severity of IVH as well as NEC. Our study showed NEC incidence was 0—10%, averaging 5.8%, versus our previous report at 15% [No observable negative effects occurred; most importantly, there were no cases of polycythemia, or neonatal death, and no maternal postpartum hemorrhage or death. Another benefit was that hypothermia incidence was reduced by half, compared to our prior intervention period. Shirk SK, et al. reported that performing DCC or UCM in low birthweight infants made the infants warmer than immediate cord clamping as placental transfusion gives warm blood [Our study was novel in comparing DCM-B and DCM-A to DCC in a randomized controlled trial. However, our outcomes lacked statistical significance because the sample size was small. Compared to previous studies, the number of preterm infants requiring transfusions in our study was also lower. This may be due to the difference in GA; the preterm infants in our study delivered at GA of GA 28