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Vol 91, No 10 (2020)
Research paper
Published online: 2020-10-21
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The risk of hyperbilirubinemia in term neonates after placental transfusion — a randomized-blinded controlled trial

Joanna P. Seliga-Siwecka1, Joanna Puskarz-Gasowska1, Justyna Tolloczko1
DOI: 10.5603/GP.a2020.0096
·
Pubmed: 33184830
·
Ginekol Pol 2020;91(10):613-619.
Affiliations
  1. Department of Neonatology and Intensive Care Unit, Faculty of Medicine, Medical University of Warsaw, Poland

open access

Vol 91, No 10 (2020)
ORIGINAL PAPERS Obstetrics
Published online: 2020-10-21

Abstract

Objective: We aimed to demonstrate non-inferiority of delayed cord clamping (DCC) and cord milking (CM) in comparison to early cord clamping (ECC) in the incidence of hyperbilirubinemia requiring phototherapy. Material and methods: 467 of maternal-foetal dyads were screened for eligibility. 389 term infants, of breastfeeding, non-smoking mothers were randomized to receive ECC ( < 40 s), DCC (1–2 min) or CM (4 times towards the neonate). The primary outcome was defined as hyperbilirubinemia requiring phototherapy. Results: 307 patients were included in the analysis. CM did not increase the risk of phototherapy RR 11.27 95% CI (0.80; 2.04). Similar results were achieved when comparing DCC and ECC, RR 1.29 95% CI (0.82; 2.05). This was also true for CM vs DCC, RR 0.99 95% CI (0.64; 1.52). The prevalence of total serum bilirubin (TSB) at 24–48 hours was 10.8 mg/dL; 10.33 mg/dL and 11.39 in ECC, CM and DCC group respectively. Transcutaneous bilirubin (TcB) levels at 24–48 h were 7.58 mg/dL, 7.89 mg/dL and 7.60 mg/dL in the ECC, CM and DCC respectively. None of the neonates met exchange transfusion criteria or symptomatic polycythaemia. Conclusions: Our study suggests that placental transfusion is not associated with hyperbilirubinemia requiring phototherapy or exchange transfusion.

Abstract

Objective: We aimed to demonstrate non-inferiority of delayed cord clamping (DCC) and cord milking (CM) in comparison to early cord clamping (ECC) in the incidence of hyperbilirubinemia requiring phototherapy. Material and methods: 467 of maternal-foetal dyads were screened for eligibility. 389 term infants, of breastfeeding, non-smoking mothers were randomized to receive ECC ( < 40 s), DCC (1–2 min) or CM (4 times towards the neonate). The primary outcome was defined as hyperbilirubinemia requiring phototherapy. Results: 307 patients were included in the analysis. CM did not increase the risk of phototherapy RR 11.27 95% CI (0.80; 2.04). Similar results were achieved when comparing DCC and ECC, RR 1.29 95% CI (0.82; 2.05). This was also true for CM vs DCC, RR 0.99 95% CI (0.64; 1.52). The prevalence of total serum bilirubin (TSB) at 24–48 hours was 10.8 mg/dL; 10.33 mg/dL and 11.39 in ECC, CM and DCC group respectively. Transcutaneous bilirubin (TcB) levels at 24–48 h were 7.58 mg/dL, 7.89 mg/dL and 7.60 mg/dL in the ECC, CM and DCC respectively. None of the neonates met exchange transfusion criteria or symptomatic polycythaemia. Conclusions: Our study suggests that placental transfusion is not associated with hyperbilirubinemia requiring phototherapy or exchange transfusion.

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Keywords

jaundice; hyperbilirubinemia; neonate; placental transfusion

About this article
Title

The risk of hyperbilirubinemia in term neonates after placental transfusion — a randomized-blinded controlled trial

Journal

Ginekologia Polska

Issue

Vol 91, No 10 (2020)

Article type

Research paper

Pages

613-619

Published online

2020-10-21

Page views

1009

Article views/downloads

1017

DOI

10.5603/GP.a2020.0096

Pubmed

33184830

Bibliographic record

Ginekol Pol 2020;91(10):613-619.

Keywords

jaundice
hyperbilirubinemia
neonate
placental transfusion

Authors

Joanna P. Seliga-Siwecka
Joanna Puskarz-Gasowska
Justyna Tolloczko

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