Association of delayed cord clamping with acute kidney injury and two-year kidney outcomes in extremely premature neonates: a secondary analysis of the preterm erythropoietin neuroprotection trial (PENUT)

Abstract

Delayed cord clamping (DCC) occurs in most preterm births. Evaluate the association of DCC with acute kidney injury (AKI) and two-year kidney outcomes. Secondary analysis of the Preterm Erythropoietin Neuroprotection Trial of neonates born 240/7 to 276/7 weeks gestation. AKI and two year kidney outcomes were compared in neonates with DCC ( ≥ 30 s after delivery) to those with early cord clamping (ECC) (<30 s after delivery). The incidence and severity of AKI did not differ between the DCC and ECC groups (aOR 1.17 [95%CI 0.76–1.80]). At two years corrected age, DCC was associated with a 4.5-fold increased adjusted odds of estimated glomerular filtration rate (eGFR) <90 mL/min/1.73m2. No significant associations were noted between DCC and albuminuria or elevated blood pressure. DCC was not associated with decreased neonatal AKI, but was associated with higher adjusted odds of eGFR <90 mL/min/1.73m2 at two years.