The Relationship Between Placental Transfusion, and Thymic Size and Neonatal Morbidities in Premature Infants - a Randomized Control Tiral. | [Journal of Pakistan Medical Association • 2018]

Author(s):

1. Musa Silahli: Department of Neonatology, Sivas Government Hospital, Sivas,

2. Enes Duman: Department of Radiology, Baskent University Hospital, Konya, Turkey

3. Zeynel Gokmen: Department of Neonatology, Baskent University Hospital, Konya, Turkey

4. Erzat Toprak: Department of Gynecology and Obstetry, Baskent University Hospital, Konya, Turkey

5. Mahmut Gokdemir: Department of Pediatric Cardiology, Baskent University Hospital, Konya,

6. Ayse Ecevit: Department of Neonatology, Baskent University Hospital, Ankara, Turkey

Abstract:

Objectives: To compare the effect of umbilical cord milking and early cord clamping on thymic size, and neonatal mortality and morbidity in preterm infants. Methods: This single-center, prospective, double-blind, randomised controlled study was conducted at Baskent University, Konya Education and Research Centre, Konya, Turkey, between October 2015 and April 2016. Pregnant women who delivered before 32 weeks of gestation were randomised to receive umbilical cord milking (group 1) or early cord clamping (group 2). Ultrasonographic evaluation was performed in each newborn by an experienced radiologist within the first 24 hours of life. Thymic size was estimated in line with literature. SPSS 15 was used for all data analyses. Results: There were 38 subjects in group 1 and 37 in group 2. There were as many infants in the two groups (p>0.05) The haemoglobin levels was higher in group 1, but not significantly (p=0.213). The absolute neutrophil count in group 1 was significantly lower (p= 0.017) than group 2. In terms of neonatal mortaility and morbidity, there were no significant differences between the groups (p>0.05). Conclusion: Umbilical cord milking was not associated with thymic size during the the first 24h of life.

Page(s): 1560-1565

DOI: DOI not available

Published: Journal: Journal of Pakistan Medical Association, Volume: 68, Issue: 11, Year: 2018

Keywords:

Placental Transfusion , Thymic size , Premature infant , Perinatal moribidities

References:

[1] AabyP,MarxC,TrautnerS,RudaaD,HasselbalchH,JensenH,JingangGui,Dong-MingSu, 2012.Thymus Size and Age-related Thymic Involution: Early Programming, Sexual Dimorphism, Progenitors and Stroma,Aging Dis 3 280 -90

[2] SavinoW., 2002.The thymus gland is a target in malnutrition,Eur J Clin Nutr 56 S46 -9

[3] SavinoW., 2006.The thymus is a common target organ in infectious diseases,PLoS Pathog 6 e62 -

[4] RaqibR,AhmedS,SultanaR,WagatsumaY,MondalD,HoqueAM, 2009.Effects of in utero arsenic exposure on child immunity and morbidity in rural Bangladesh,Toxicol Lett 185 197 -202

[5] 1976.Persistentcell mediated immune-deficiency following infantile stress during thefirst 6 months of life,Eur J Pediatr 122 117 -30

[6] GoenkaA,KollmannTR, .Development of immunity in early life,2015; Suppl 1 S112 -20

[7] UpadhyayA,GothwalS,PariharR,GargA,GuptaA,ChawlaD, 2013.Effect of umbilical cordmilking in term and near term infants: randomized control trial,Am J Obstet Gynecol 208 120 -6

[8] RabeH,Diaz-RosselloJL,DuleyL,DowswellT, 2012.Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes,Cochrane Database Syst Rev 8 CD003248 -

[9] HanelineLS,MarshallKP,ClappDW, 1996.The highest concentration of primitive hematopoietic progenitor cells in cord blood is found in extremely premature infants Pediatr Res, 39 820 -5

[10] HosonoS,MugishimaH,FujitaH,HosonoA,MinatoM,OkadaT, 2008.Umbilical cord milking reduces the need for red cell transfusions and improves neonatal adaptation in infants born at less than 29 weeks' gestation: a randomised controlled trial,Arch Dis Child Fetal Neonatal Ed 93 F14 -9

[11] 2015.n e p i . c o m / S a m p l e S i z e / S S M e a n . h t m, -

[12] WyckoffMH,AzizK,EscobedoMB,KapadiaVS,KattwinkelJ,PerlmanJM, 2015.neonatal resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care,Circulation 132 S543 -60

[13] KatheriaAC,LeoneTA,WoelkersD,GareyDM,RichW,FinerNN, 2014.The effects of umbilical cordmilking on hemodynamics and neonatal outcomes in premature neonates,J Pediatr 5 1045 -50

[14] TakamiT,SuganamiY,SunoharaD,KondoA,MizukakiN,FujiokaT, 2012.Umbilicalcordmilkingstabilizescerebraloxygenation and perfusion in infants born before 29 weeks of gestation,J Pediatr 4 742 -7

[15] AhmedS,AhsanKB,KipplerM,MilyA,WagatsumaY,HoqueAM, 2012.In utero arsenic exposure is associated with impaired thymic function innewborns possibly via oxidative stress and apoptosis,Toxicol Sci 129 305 -14

[16] NgomPT,CollinsonAC,Pido-LopezJ,HensonSM,PrenticeAM,AspinallR, 2004.Improved thymic function in exclusively breastfed infantsis associated with higher interleukin 7 concentrations in their mothers'breast milk,Am J Clin Nutr 80 722 -8

[17] KilicdagH,GulcanH,HantaD,TorerB,GokmenZ,OzdemirS I, 2016.Is umbilical cord milking always an advantage?,J Matern Fetal Neonatal Med 4 615 -8

[18] RochaV,LabopinM,SanzG,ArceseW,SchwerdtfegerR,Bosi, 2004.Transplants of umbilical-cord blood or bone marrow from unrelated donors in adults with acute leukemia,N Engl J Med 351 2276 -85

[19] RodriguesCA,RochaV,DregerP,BrunsteinC,SengeloevH,FinkeJ, 2014.Alternative donor hematopoietic stem cell transplantation for mature lymphoid malignancies after reduced-intensity conditioning regimen: similar outcomes with umbilical cord blood and unrelated donor peripheral blood,Haematologica 99 370 -7

[20] MooreSE,FulfordAJ,WagatsumaY,PerssonLÅ,ArifeenSE,PrenticeAM, 2014.Thymus development and infant and child mortality in rural Bangladesh,Int J Epidemiol 1 216 -23

[21] HosonoS,MugishimaH,TakahashiS,TakahashiS,MasaokaN,YamamotoT, 2015.One-time umbilical cord milking after cord cutting has same effectiveness as multiple-time umbilical cord milking in infants born at <29 weeks of gestation: a retrospective study,J Perinatol 8 590 -4

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