What is it about?

Blood loss in the first days of life has been associated with increased risk of death and diseases in very preterm infants, that is babies born too early. In this project we included experimental studies comparing the effects of interventions to preserve blood volume in the infant from birth, reduce the need for sampling, or limit the blood sampled. Mortality and abnormal development were the primary outcomes. We included 31 experimental studies enrolling 3,759 infants. Twenty-five experimental studies were pooled in the comparison delayed cord clamping or cord milking vs. immediate cord clamping or no milking. Increasing placental transfusion resulted in lower mortality during the neonatal period and during first hospitalization. The six remaining experimental studies compared devices to monitor glucose levels, blood sampling from the umbilical cord or from the placenta vs. blood sampling from the infant, and devices to reintroduce the blood after analysis vs. conventional blood sampling.

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Why is it important?

Increasing placental transfusion at birth may reduce mortality in very preterm infants; However, extremely limited evidence is available to assess the effects of other interventions to reduce blood loss after birth.

Perspectives

Future studies might compare different blood saving approaches, to be added-on to following placental transfusion.

Matteo Bruschettini
Lunds Universitet

Read the Original

This page is a summary of: Interventions to minimize blood loss in very preterm infants—A systematic review and meta-analysis, PLoS ONE, February 2021, PLOS,
DOI: 10.1371/journal.pone.0246353.
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