A cluster randomized clinical trial of umbilical cord milking to improve short and long-term outcomes in neonates who are non-vigorous at birth

Ended Project Grant Awarded Last action

Award ID
R01HD102967
Recipient
Awarding agency
Obligated
$3,456,589

Award facts

Completion date
Originally
Funding
  • $2,899,143.00 Federal
  • $557,446.00 Non-federal
Place of performance
Delaware, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
At birth, IT is critical that an infant begins breathing quickly. The infant has to switch from relying on the placenta for oxygen to using its lungs for the first time. Worldwide each year, 10 million babies do not breathe immediately at birth, and approximately one million babies DIE annually in low and middle-income countries due to a brain injury caused by inadequate blood flow and oxygen delivery to the neonatal brain, a condition known as hypoxic ischemic encephalopathy (HIE). The usual practice for infants who need resuscitation is to immediately clamp the umbilical cord. Animal studies show that clamping the cord before the baby breathes can cause the heart beat to slow and can decrease the amount of blood being pumped out of the heart each minute. We propose a study to see if umbilical cord milking (UCM) for those infants who need resuscitation is better than immediately clamping and cutting the umbilical cord at birth. We wonder if IT will reduce death and/or HIE. In addition, IT may reduce developmental problems in survivors by two years of age. This study is important because when there is need for resuscitation, neither UCM or delayed cord clamping, are recommended by national and international organizations due to lack of evidence. Yet, several large studies fromaround the world have identified that infants needing resuscitation are more likely to DIE or develop conditions such as cerebral palsy, autism and other developmental problems. The large amount of fetal blood left in the placenta after immediate cord clamping means that the baby gets less blood for the brain, lungs, and heart, which can contribute, to brain injury and even death. Cord milking at birth may help to protect these infants by increasing the transfer of blood volume. Our prior work has shown that, compared to immediate cord clamping, UCM results in better heart rate, blood pressure, less early anemia, and more oxygen in the brain. No harm from UCM has been noted in term infants in any studies. We will use a design in which each hospital will be randomly assigned to use either immediate cord clamping or UCM for any infant needing resuscitation over a period of 6 months. Then sites will change to the other method for an additional 6 months. This trial will involve 3442 term newborns who are depressed at birth at seven (7) hospitals in india. This trial will provide evidence to promote a change in guidelines supporting the use of UCM - a simple, no-cost intervention as standard of care in term and near-term newborns needing resuscitation.

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Subawards

Subrecipient Amount Awarded
K L E Society's Jawaharlal Nehru Medical College This amendment revises the above-referenced Subaward Agreement to provide additional funding in the amount of $121,568 for the budget period 08/01/2025 –… $121,568
Thomas Jefferson University Revises Subaward Budget Peri od: The previous Subaward Budget Peri od (August 1, 2023 - July 31, 2024) is extended with a new end date of July 31, 2025, with… $61,736
Sharp Mary Birch Hospital For Women And Newborns Prematurity is the leading cause of death in children younger than 5 years of age. Approximately 1 million children die each year due to complications of… $30,000
University Of California, San Diego Dr. Vaucher will be a Co-investigator for the project and will provide oversight for neurodevelopmental assessment project along with a Senior Developmental… $9,661
K L E Society's Jawaharlal Nehru Medical College The “Women’s and Children’s Health Unit� (WCRU) at JNMC will assist in conducting the CORDMILK trial. The WCRU was established in… $330,627
Thomas Jefferson University Approximately one million babies die annually in low and middle-income countries (LMICs) due to a brain injury caused by inadequate blood flow and oxygen… $61,736
Sharp Mary Birch Hospital For Women And Newborns Over 10 million term and near-term non-vigorous newborns are born every year, at risk for significant public health implications and long-term morbidities. This… $41,387
K L E Society's Jawaharlal Nehru Medical College The goal of the CORDMILK trial is to determine if umbilical cord milking compared to early cord clamping will improve short and long-term outcomes in neonates… $227,662

Quick answers

Who received award R01HD102967?

R01HD102967 was awarded to The Nemours Foundation by National Institute of Child Health and Human Development (National Institutes of Health) on August 1, 2021.

How much is award R01HD102967 worth?

$3,456,589 has been obligated on R01HD102967: $2,899,143 in federal funding and $557,446 in non-federal funding.

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