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

Abstract

OBJECTIVE\n\u2003Umbilical 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\u2009hours of life.\n\n\nSTUDY DESIGN\n\u2003A randomized control trial among VLBW infants whose admission laboratories were drawn from UCB (n\u2009=\u200939) or the infant (n\u2009=\u200941) in three U.S. military NICUs (clinicaltrials.gov#NCT02103296).\n\n\nRESULTS\n\u2003No demographic differences were observed between groups. UCB infants had higher [HgB] at 12 to 24\u2009hours of life (15.5 vs. 14.0\u2009g/dL, p\u2009=\u20090.02). The median time to first transfusion was 17 days longer in the experimental group (p\u2009=\u20090.04), and at discharge, their number of donor exposures was lower (1.1 vs. 1.8, p\u2009=\u20090.04).\n\n\nCONCLUSION\n\u2003In the first 24\u2009hours of life that is a period of higher risk for hemodynamic instability, UCB utilization for admission bloodwork in VLBW infants results in higher [HgB].\n\n\nKEY POINTS\n· Umbilical cord blood laboratory work in preterm infants is feasible.. · Cord blood use for admission laboratories results in increased hemoglobin in the first 24\u2009hours of life.. · Cord blood use for admission laboratories delays time to first transfusion in preterm infants..