Katalin Gombos, Róbert Herczeg, Bálint Erőss, Sándor Zsolt Kovács, Annamária Uzzoli, Tamás Nagy, Szabolcs Kiss, Zsolt Szakács, Marcell Imrei, Andrea Szentesi, Anikó Nagy, Attila Fábián, Péter Hegyi, Attila Gyenesei
Translating Scientific Knowledge to Government Decision Makers Has Crucial Importance in the Management of the COVID-19 Pandemic
Population health management
providing assisted ventilation delayed umbilical cord clamping may improve outcomes extremely preterm infants determine whether assisted ventilation extremely preterm infants 23 07 28 67 weeks gestational age ga followed cord clamping reduces intraventricular hemorrhage ivh early death phase 3 11 parallelstratified randomized clinical trial conducted 12 perinatal centers across us canada september 2 2016 february 21 2023 assessed ivh early death outcomes extremely preterm infants randomized receive 120 seconds assisted ventilation followed cord clamping vs delayed cord clamping 30 60 seconds ventilatory assistance afterward two analysis cohorts breathing well breathing well specified priori based assessment breathing 30 seconds birth birth infants received stimulation suctioning needed 30 120 seconds infants randomized intervention received continuous positive airway pressure breathing well positivepressure ventilation cord clamping 120 seconds control infants received 30 60 seconds delayed cord clamping followed standard resuscitation primary outcome grade ivh head ultrasonography death day 7 interpretation site radiologists confirmed independent radiologists masked study group estimate association study group outcome data analyzed using stratified cochranmantelhaenszel test relative risk rr associations summarized point estimates 95 cis 1110 women consented participate 548 randomized delivered infants ga less 29 weeks total 570 eligible infants enrolled median iqr ga 266 249277 weeks 297 male 521 intraventricular hemorrhage death occurred 349 97 278 infants intervention group 325 95 292 control group adjusted rr 102 95 ci 081127 prespecified notbreathingwell cohort 475 271 570 median iqr ga 260 247274 weeks 152 male 561 ivh death occurred 387 58 150 infants intervention group 430 52 121 control group rr 091 95 ci 068121 evidence differences death severe brain injury major morbidities intervention control groups either breathing cohort study show providing assisted ventilation cord clamping extremely preterm infants reduces ivh early death additional study around feasibility safety efficacy assisted ventilation cord clamping may provide additional insight clinicaltrialsgov identifier nct02742454