A Comparison of Strategies for Managing the Umbilical Cord at Birth in Preterm Infants

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Of 12749 admitted infants, 9729 were included; 4916 (50.5%) received ECC, 394 (4.1%) UCM, and 4419 (45.4%) DCC. After adjust ment for potential confounders identified between groups in univariate analyses, the odds of mortality or major morbidity were higher in the ECC group when compared with UCM group (aOR 1.18; 95% CI: 1.03, 1.35). Mortality and intraventricular hemorrhage were associated with ECC as compared with DCC (aOR [95% CI] 1.6 [1.22, 2.1] and 1.29 [1.19, 1.41], respectively). The odds of severe intraventricular hemorrhage were higher with UCM compared with DCC (aOR 1.38; 95% CI: 1.05, 1.81). Rates of blood transfusion were higher with ECC compared with UCM and DCC (aOR [95%CI] 1.67 [1.31, 2.14] and 1.68 [1.35, 2.09], respectively), and peak serum bilirubin levels were not significantly different.

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