***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : The results from our previous trial revealed that infants with delayed cord clamping ( DCC )  had significantly lesser intraventricular hemorrhage ( IVH ) and late-onset sepsis ( LOS ) than infants with immediate cord clamping ( ICC ) . A priori , we hypothesized that infants with DCC would have better motor function by 7 months corrected age . Study Design : Infants between 24 and 31 weeks were r and omized to ICC or DCC and follow-up evaluation was completed at 7 months corrected age . Result : We found no differences in the Bayley Scales of Infant Development ( BSID ) scores between the DCC and ICC groups . However , a regression model of effects of DCC on motor scores controlling for gestational age , IVH , bronchopulmonary dysplasia , sepsis and male gender suggested higher motor scores of male infants with DCC . Conclusion : DCC at birth seems to be protective of very low birth weight male infants against motor disability at 7 months corrected age OBJECTIVE : This pilot study 's aim was to establish feasibility of a protocol for delayed cord clamping ( DCC ) versus immediate cord clamping ( ICC ) at preterm birth and to examine its effects on initial blood pressure and other outcomes . STUDY DESIGN : A r and omized controlled trial recruited 32 infants between 24 and 32 weeks . Immediately before delivery , mothers were r and omized to ICC ( cord clamped at 5 to 10 seconds ) or DCC ( 30- to 45-second delay in cord clamping ) groups . RESULTS : Intention-to-treat analyses revealed that the DCC group were more likely to have higher initial mean blood pressures ( adjusted OR 3.4 ) and less likely to be discharged on oxygen ( adjusted OR 8.6 ) . DCC group infants had higher initial glucose levels ( ICC=36 mg/dl , DCC=73.1 mg/dl ; p=0.02 ) . CONCLUSION : The research design is feasible . The immediate benefit of improved blood pressure was confirmed and other findings deserve consideration for further study Objective : To investigate the effects of umbilical cord milking on cardiopulmonary adaptation in very low birth weight infants . Patients and methods : This study was the secondary analysis of a r and omised control study of the effect of umbilical cord milking in premature infants . Forty singleton infants born between 24 and 28 weeks ’ gestation were r and omly assigned to groups in which the umbilical cord was clamped either immediately after birth ( control group , n = 20 ) or after umbilical cord milking ( milked group , n = 20 ) . Blood pressure , heart rate , urine output , fluid intake , and ventilatory index values in both groups were measured during the first 120 h after birth . Results : There were no significant differences in gestational age or birth weight between the two groups . The initial haemoglobin value was higher in the milked group ( mean ( SD ) 16.5 ( 1.4 ) g/dl in the milked vs 14.1 ( 1.6 ) g/dl in the control ; p<0.01 ) . During the first 12 h , blood pressure was significantly higher in the milked group . Urine output in the milked group was higher than that in the control group during the first 72 h. There were no significant differences in heart rate , water intake , or ventilatory index values between the groups . Conclusion : Umbilical cord milking may facilitate early stabilisation of both blood pressure and urine output in very low birth weight infants Abstract Aim : To evaluate the immunologic and infectious consequences of delayed versus immediate cord clamping in premature infants ( < 35 weeks ) during the neonatal period . Methods : This was a prospect i ve , masked , r and omized , controlled , single-center study . Prior to delivery 35 infants were r and omly assigned to immediate cord clamping ( ICC ) at 5–10 s and 30 infants to delayed cord clamping ( DCC ) , at 30–45 s ( 14 and 15 infants in each group were < 1500 g , respectively ) . Results : Neonatal characteristics of the ICC and DCC groups were comparable . There was no significant difference between the ICC and DCC groups in the complement or in the immunoglobulin levels . All were within the normal range for age . All infectious parameters ( events of sepsis or “ rule-out sepsis ” , days of antibiotic therapy , and number of antibiotic courses during hospitalization and infections within the first month of life in cases of earlier discharge ) were comparable in both groups . Similar results were found in the subgroup of infants < 1500 g. Gender analysis showed only modest differences . Conclusions : Delayed compared to immediate cord clamping did not affect the immunologic or the infectious status of infants born at < 35 weeks during the neonatal period Objective : Delayed cord clamping has been shown to decrease the need for transfusion in preterm neonates , but may delay resuscitation . The aim of this study was to determine whether umbilical cord milking compared with immediate cord clamping in extremely preterm deliveries reduces the need for neonatal red blood cell transfusion . Study design : Women admitted to a tertiary care center and expected to deliver between 24 to 28 completed weeks of gestation were r and omized to cord milking before clamping or immediate cord clamping . The primary outcome was the risk of neonatal transfusion , reported as risk ratio ( RR ) and 95 % confidence interval ( CI ) . Result : Of 113 women who were enrolled and r and omized , 56 were assigned to cord milking  with 36 remaining eligible and completing the study and 57 were assigned to the control group  with 39 remaining eligible and completing the study . Albeit not statistically significant , neonates in the cord milking group were less likely to require transfusion compared with those in the control group ( RR : 0.86 ; 95 % CI : 0.73 to 1.0 ) . Neonates whose cords were milked had higher hematocrits at birth ( P=0.004 ) and were less likely to develop an intraventricular hemorrhage ( P=0.0195 ) . Conclusion : Milking the umbilical cord of a preterm neonate is an easy intervention with the potential to improve perinatal outcomes . Our results suggest that milking of the cord increases the neonate ’s initial hematocrit and may lessen the need for transfusion in the neonatal period . The observed reduction in the incidence of intraventricular hemorrhage may have important long-term implication s that warrant further study Abstract This study was carried out to assess the feasibility of late cord clamping of 45 s in preterm infants delivered mainly by caesarean section and the effects on post-partal adaptation and anaemia of prematurity . Prior to delivery , 40 infants of <33 gestational weeks were r and omised to either 20 s or 45 s of late cord clamping . After the first shoulder was delivered , oxytocin was given intravenously to the mother in order to enhance placento-fetal transfusion while the infant was held below the level of the placenta . The 20 infants in group 1 ( 20 s ) had a mean birth weight of 1070 g and a mean gestational age of 29 + 4/7 weeks versus 1190 g and 30 weeks in group 2 ( 45 s ) . On day 42 of life there were ten infants without transfusions in group 2 versus three in group 1 ( P < 0.05 ) . Out of the 20 infants in group 1 , 19 and 15/19 in group 2 were delivered by caesarean section . There were no significant differences in Apgar scores , temperature on admission , heart rate , blood pressure and requirements for artificial ventilation . Conclusion Delayed cord clamping of 45 s is feasible and safe in preterm infants below 33 weeks of gestation . It is possible to perform the procedure at caesarean section deliveries and it should be performed whenever possible . It reduces the need for packed red cell transfusions during the first 6 weeks of life OBJECTIVE . This study compared the effects of immediate ( ICC ) and delayed ( DCC ) cord clamping on very low birth weight ( VLBW ) infants on 2 primary variables : bronchopulmonary dysplasia ( BPD ) and suspected necrotizing enterocolitis ( SNEC ) . Other outcome variables were late-onset sepsis ( LOS ) and intraventricular hemorrhage ( IVH ) . STUDY DESIGN . This was a r and omized , controlled unmasked trial in which women in labor with singleton fetuses < 32 weeks ’ gestation were r and omly assigned to ICC ( cord clamped at 5–10 seconds ) or DCC ( 30–45 seconds ) groups . Women were excluded for the following reasons : their obstetrician refused to participate , major congenital anomalies , multiple gestations , intent to withhold care , severe maternal illnesses , placenta abruption or previa , or rapid delivery after admission . RESULTS . Seventy-two mother/infant pairs were r and omized . Infants in the ICC and DCC groups weighed 1151 and 1175 g , and mean gestational ages were 28.2 and 28.3 weeks , respectively . Analyses revealed no difference in maternal and infant demographic , clinical , and safety variables . There were no differences in the incidence of our primary outcomes ( BPD and suspected NEC ) . However , significant differences were found between the ICC and DCC groups in the rates of IVH and LOS . Two of the 23 male infants in the  DCC group had IVH versus 8 of the 19 in the ICC group . No cases of sepsis occurred in the 23 boys in the DCC group , whereas 6 of the 19 boys in the ICC group had confirmed sepsis . There was a trend toward higher initial hematocrit in the infants in the DCC group . CONCLUSIONS . Delayed cord clamping seems to protect VLBW infants from IVH and LOS , especially for male infants BACKGROUND Policies for timing of cord clamping vary , with early cord clamping generally carried out in the first 60 seconds after birth , whereas later cord clamping usually involves clamping the umbilical cord more than one minute after the birth or when cord pulsation has ceased . The benefits and potential harms of each policy are debated . OBJECTIVES To determine the effects of early cord clamping compared with late cord clamping after birth on maternal and neonatal outcomes SEARCH METHODS We search ed the Cochrane Pregnancy and Childbirth Group 's Trials Register ( 13 February 2013 ) . SELECTION CRITERIA R and omised controlled trials comparing early and late cord clamping . DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial eligibility and quality and extracted data . MAIN RESULTS We included 15 trials involving a total of 3911 women and infant pairs . We judged the trials to have an overall moderate risk of bias . MATERNAL OUTCOMES : No studies in this review reported on maternal death or on severe maternal morbidity . There were no significant differences between early versus late cord clamping groups for the primary outcome of severe postpartum haemorrhage ( risk ratio ( RR ) 1.04 , 95 % confidence interval ( CI ) 0.65 to 1.65 ; five trials with data for 2066 women with a late clamping event rate ( LCER ) of ~3.5 % , I(2 ) 0 % ) or for postpartum haemorrhage of 500 mL or more ( RR 1.17 95 % CI 0.94 to 1.44 ; five trials , 2260 women with a LCER of ~12 % , I(2 ) 0 % ) . There were no significant differences between subgroups depending on the use of uterotonic drugs . Mean blood loss was reported in only two trials with data for 1345 women , with no significant differences seen between groups ; or for maternal haemoglobin values ( mean difference ( MD ) -0.12 g/dL ; 95 % CI -0.30 to 0.06 , I(2 ) 0 % ) at 24 to 72 hours after the birth in three trials . NEONATAL OUTCOMES : There were no significant differences between early and late clamping for the primary outcome of neonatal mortality ( RR 0.37 , 95 % CI 0.04 to 3.41 , two trials , 381 infants with a LCER of ~1 % ) , or for most other neonatal morbidity outcomes , such as Apgar score less than seven at five minutes or admission to the special care nursery or neonatal intensive care unit . Mean birthweight was significantly higher in the late , compared with early , cord clamping ( 101 g increase 95 % CI 45 to 157 , r and om-effects model , 12 trials , 3139 infants , I(2 ) 62 % ) . Fewer infants in the early cord clamping group required  phototherapy for jaundice than in the late cord clamping group ( RR 0.62 , 95 % CI 0.41 to 0.96 , data from seven trials , 2324 infants with a LCER of 4.36 % , I(2 ) 0 % ) . Haemoglobin concentration in infants at 24 to 48 hours was significantly lower in the early cord clamping group ( MD -1.49 g/dL , 95 % CI -1.78 to -1.21 ; 884 infants , I(2 ) 59 % ) . This difference in haemoglobin concentration was not seen at subsequent assessment s. However , improvement in iron stores appeared to persist , with infants in the early cord clamp 
    Output:
    
Providing additional placental blood to the preterm baby by either delaying cord clamping for 30 to 120 seconds , rather than early clamping , seems to be associated with less need for transfusion , better circulatory stability , less intraventricular haemorrhage ( all grade s ) and lower risk for necrotising enterocolitis .