Impact of Delayed Umbilical Cord Clamping on Days of Phototherapy in Preterm Neonates 23–35 Weeks’ Gestation - A Retrospective, Single-Center Cohort Study

OBJECTIVE: To evaluate whether delayed cord clamping (DCC) duration predicts hyperbilirubinemia and phototherapy days among preterm infants of different gestational ages. STUDY DESIGN: In this retrospective cohort study, 2,421 preterm infants inborn at Magee-Womens Hospital 2018-22 were stratified into 3 cohorts: <27wks (n=206), 27-30 6/7wks (n=464), and 31-34 6/7wks (n=1751). DCC duration was assessed in 15 second intervals (0, 15, 30, 45, 60, >65sec). Univariable analysis and multivariable regression assessed predictors of phototherapy days. RESULTS: DCC occurred in 30%, 44%, and 63% of the cohorts, respectively. In univariable analysis, DCC was associated with higher hemoglobin, peak bilirubin, and phototherapy days for the 31-34 6/7wk cohort only. DCC duration did not predict phototherapy days in adjusted multivariable analysis. CONCLUSION: Longer durations of DCC are not associated with increased phototherapy days in preterm neonates, supporting DCC safety and emphasizing the need to address barriers to consistent implementation.