Antenatal Prediction of Early Cord Clamping among Infants Born Extremely Preterm

Authors

• Anup C Katheria
• Rebecca A Dorner
• William A Grobman
• Matthew A Rysavy
• Jenny Koo
• Myra H Wyckoff
• Grecio Sandoval
• Sara B DeMauro
• Abhik Das
• Henry C Lee
• Michael Cotten
• Laura Calvo
• Shampa Saha

Language

English

Publication Date

2-1-2026

Journal

The Journal of Pediatrics

DOI

10.1016/j.jpeds.2025.114878

PMID

41177398

PMCID

PMC12799206

PubMedCentral® Posted Date

1-14-2026

PubMedCentral® Full Text Version

Author MSS

Abstract

Objective: To identify prenatal risk factors associated with early cord clamping (ECC) in infants born extremely preterm (22-28 weeks) and to use these factors to predict which infants have the highest risk of ECC.

Study design: Stepwise logistic regression and classification and regression tree analysis were performed to identify variables most associated with ECC and to build a parsimonious model to identify infants born preterm who are at the highest risk of ECC.

Results: There were 12 622 infants eligible for analysis (ECC, n = 8465 vs deferred cord clamping [DCC], n = 4157). In the classification and regression tree model, center, lack of antenatal magnesium, cesarean delivery, lower gestational age, and antenatal hemorrhage, in that rank order, were the factors that contributed most to identifying which infants received ECC. Several additional factors were also statistically significant, including time to delivery after admission to the hospital as well as maternal race and ethnicity.

Conclusions: Our results suggest that there are multiple factors among extremely preterm pregnancies, including center, lack of antenatal magnesium, cesarean delivery, lower gestational age, and antenatal hemorrhage, that are associated with infants who are more likely to miss DCC. There are also differences in rates by maternal race and ethnicity in who receives DCC compared with ECC. Identifying these factors now can inform future research and encourage local and larger-scale quality improvement practice changes.

Keywords

Humans, Infant, Newborn, Female, Infant, Extremely Premature, Pregnancy, Umbilical Cord Clamping, Risk Factors, Gestational Age, Male, Logistic Models, Time Factors, Umbilical Cord

Published Open-Access

yes

Recommended Citation

Katheria, Anup C; Dorner, Rebecca A; Grobman, William A; et al., "Antenatal Prediction of Early Cord Clamping among Infants Born Extremely Preterm" (2026). Faculty, Staff and Student Publications. 4244.
https://digitalcommons.library.tmc.edu/uthmed_docs/4244