Am J Perinatol
DOI: 10.1055/s-0041-1733781
Original Article

Umbilical Cord Blood Use for Admission Blood Tests of VLBW Preterm Neonates: A Randomized Control Trial

1  Department of Pediatrics, Brooke Army Medical Center, San Antonio, Texas
Alicia C. Prescott
2  Department of Pediatrics, Tripler Army Medical Center, Honolulu, Hawaii
Gayle D. Haischer-Rollo
1  Department of Pediatrics, Brooke Army Medical Center, San Antonio, Texas
James K. Aden
3  Department of Graduate Education, Brooke Army Medical Center, San Antonio, Texas
Jonathan B. Shapiro
1  Department of Pediatrics, Brooke Army Medical Center, San Antonio, Texas
› Author Affiliations
Funding The team received support from the Air Force Surgeon General FY2015 Intramural Program for trainee research.
Funding None.


Objective Umbilical cord blood (UCB) for admission laboratories is an approach to decrease anemia risk in very low birth weight (VLBW) neonates. We hypothesized that UCB use results in higher hemoglobin concentration [HgB] around 24 hours of life.

Study Design A randomized control trial among VLBW infants whose admission laboratories were drawn from UCB (n = 39) or the infant (n = 41) in three U.S. military NICUs (

Results No demographic differences were observed between groups. UCB infants had higher [HgB] at 12 to 24 hours of life (15.5 vs. 14.0 g/dL, p = 0.02). The median time to first transfusion was 17 days longer in the experimental group (p = 0.04), and at discharge, their number of donor exposures was lower (1.1 vs. 1.8, p = 0.04).

Conclusion In the first 24 hours of life that is a period of higher risk for hemodynamic instability, UCB utilization for admission bloodwork in VLBW infants results in higher [HgB].

Key Points

  • Umbilical cord blood laboratory work in preterm infants is feasible.

  • Cord blood use for admission laboratories results in increased hemoglobin in the first 24 hours of life.

  • Cord blood use for admission laboratories delays time to first transfusion in preterm infants.

Authors' Contributions

T.S.M. and A.C.P. conceptualized and designed the study and coordinated multisite recruitment. T.S.M., A.C.P., G.D.H., and J.B.S. participated in study enrollment. All authors participated in data analysis and interpretation as well as drafting, revisions, and approval of the manuscript.


All data generated or analyzed during this study are included in this article. Further inquiries can be directed to the corresponding author. The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, Tripler Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Air Force and Army, Department of Defense or the U.S. Government.

Publication History

Received: 01 June 2021

Accepted: 23 June 2021

Publication Date:
18 August 2021 (online)

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA