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

Abstract

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 (clinicaltrials.gov#NCT02103296).

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.

Keywords

umbilical cord blood - preterm infant - anemia of prematurity - hemoglobin - blood transfusion

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.

Note

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.

Publikationsverlauf

Eingereicht: 01. Juni 2021

Angenommen: 23. Juni 2021

Artikel online veröffentlicht:
18. August 2021

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