125 Delayed cord clamping for preterm infants with restricted growth for age
Bibliographic record
Abstract
Infants with restricted growth for age are frequently exposed to insufficient placental circulation and are more likely to develop postnatal complications. Delayed cord clamping (DCC) at birth for these infants requires further exploration. To compare the short-term neonatal outcomes of DCC vs. early cord clamping (ECC) in small for gestational age (SGA) preterm infants, and to explore the differences in the effects of DCC in SGA infants compared to those in non-SGA preterm infants. A national retrospective cohort study, including infants born at <33 weeks’ gestation and admitted to NICUs participating in the Canadian Neonatal Network between January 2015 and December 2017. SGA infants (birth weight <10% for gestational age and sex) who received DDC >/= 30 seconds were identified and compared with SGA infants who received ECC. Non-SGA infants who received DCC were also compared with those who received ECC. The main study outcomes were peak serum bilirubin, number of blood transfusions, short-term neonatal morbidities, mortality, and a composite outcome of mortality or major morbidity. Infants who were moribund at birth and those with major congenital anomalies were excluded. Multivariable logistic/linear regression models with generalized estimation equation (GEE) approach was used to account for clustering of infants within each hospital site, adjusted for potential confounders. 9,722 infants met inclusion criteria - distribution is described in Figure 1. The median (IQR) gestational age was 31 weeks (28,32) - Table 1. Clinical outcomes of study groups are shown in Table 2. After adjustment for potential confounders on multivariable regression analysis, DCC in SGA infants was associated with reduction in composite outcome of mortality or major morbidity (aOR 0.60, 95% CI 0.42,0.86). There was no difference between the two groups in peak serum bilirubin. Many associations of DCC in SGA infants were similar to the non-SGA infants. Other adjusted clinical outcomes are shown in Table 3. DCC in SGA preterm infants was associated with decreased odds of mortality or major morbidity. Many of the benefits of DCC in the non-SGA infants were also shown in the growth restricted infants.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".