School age outcomes of very premature infants randomized to cord milking versus early cord clamping at birth

To evaluate the effect of intact cord milking (I-UCM) compared to immediate cord clamping (ICC) on neurodevelopmental outcomes at seven years of age in very preterm infants. This prospective single-blind cohort study included children who were previously participated in a randomized controlled trial comparing I-UCM and ICC. At about 7 years of age, participants were administered the Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) and the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). A total of 31 children were included in the follow-up study. The mean age of participants was 6.4 +/- 0.5 years. The mean gestational age at birth was 28.5 +/- 1.7 weeks. There were no cases with grade >= 3 intraventriculary hemorrhage (IVH) in the present study cohort. Although the I-UCM group showed a trend toward higher median full-scale IQ, the difference was not statistically significant (p: 0.057). A significantly higher percentage of cases in the I-UCM group achived a full-scale IQ above 85 in the WISC-IV (p = 0.048). The mean of the "written language scaled score" subdomain among Vineland-II scores was found to be significantly higher in the I-UCM group. A significantly higher percentage of cases in the I-UCM group had a written language scaled score above 12 (p: 0.029).Conclusion: A comparison of I-UCM with ICC in preterm infants born at a mean age of 28 weeks and without severe IVH revealed that I-UCM did not result in long-term neurodevelopmental adverse outcomes. I-UCM even had positive effects in some subdomains of detailed neurodevelopmental tests. What is Known:center dot Compared to immediate cord clamping, umbilical cord milking improves the short-term postnatal outcomes of very preterm infants. There is a lack of robust data regarding the long-term neurodevelopmental effects of umbilical cord milking in preterm infants.What is New:center dot Among very preterm infants without severe intraventricular hemorrhage, intact umbilical cord milking was not associated with long-term adverse neurodevelopmental outcomes. Intact-umbilical cord milking even had positive effects in some subdomains of detailed neurodevelopmental tests.