Am J Perinatol 2022; 39(16): 1812-1819
DOI: 10.1055/s-0041-1726387
Original Article

Effects of Placental Transfusion on Late Preterm Infants Admitted to a Mother–Baby Unit

1   Department of Women and Infants, Baylor Scott & White Medical Center McKinney, Pediatrix Medical Group of Dallas, Dallas, Texas
,
Reshma George
2   Department of Medical Education, College of Medicine, Texas A&M University, Bryan, Texas
,
Karen C. Stanzo
1   Department of Women and Infants, Baylor Scott & White Medical Center McKinney, Pediatrix Medical Group of Dallas, Dallas, Texas
,
Cassandra M. Kindla
1   Department of Women and Infants, Baylor Scott & White Medical Center McKinney, Pediatrix Medical Group of Dallas, Dallas, Texas
,
Sujata Desai
3   Division of Neonatology, Baylor University Medical Center, Pediatrix Medical Group of Dallas, Dallas, Texas
› Author Affiliations
Funding None.

Abstract

Objective Well-appearing late preterm infants admitted to a mother baby unit may benefit from either delayed cord clamping (DCC) or umbilical cord milking (UCM). However, there are concerns of adverse effects of increased blood volume such as polycythemia and hyperbilirubinemia. The purpose of this study is to examine the short-term effects of placental transfusion on late preterm infants born between 350/7 and 366/7 weeks of gestation.

Study Design In this pre- and postimplementation retrospective cohort study, we compared late preterm infants who received placental transfusion (161 infants, DCC/UCM group) during a 2-year period after guideline implementation (postimplementation period: August 1, 2017, to July 31, 2019) to infants who had immediate cord clamping (118 infants, ICC group) born during a 2-year period before implementation (preimplementation period: August 1, 2015, to July 31, 2017).

Results The mean hematocrit after birth was significantly higher in the DCC/UCM group. Fewer infants had a hematocrit <40% after birth in the DCC/UCM group compared with the ICC group. The incidence of hyperbilirubinemia needing phototherapy, neonatal intensive care unit (NICU) admissions, or readmissions to the hospital for phototherapy was similar between the groups. Fewer infants in the DCC/UCM group were admitted to the NICU primarily for respiratory distress. Symptomatic polycythemia did not occur in either group. Median hospital length of stay was 3 days for both groups.

Conclusion Placental transfusion (DCC or UCM) in late preterm infants admitted to a mother baby unit was not associated with increased incidence of hyperbilirubinemia needing phototherapy, symptomatic polycythemia, NICU admissions, or readmissions to the hospital for phototherapy.

Key Points

  • Placental transfusion was feasible in late preterm infants.

  • Placental transfusion resulted in higher mean hematocrit after birth.

  • Placental transfusion did not increase the need for phototherapy.

  • Fewer admissions to the NICU for respiratory distress were noted in the placental transfusion group.

Note

This study was a virtual poster presentation at the American Academy of Pediatrics National Conference Exhibition, October 2 to 5, 2020.




Publication History

Received: 06 November 2020

Accepted: 10 February 2021

Article published online:
15 March 2021

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