Optimizing cord management for each preterm baby - Challenges of collating individual participant data and recommendations for future collaborative research

Anna Lene Seidler; Kylie E Hunter; Angie Barba; Mason Aberoumand; Sol Libesman; Jonathan G Williams; Nipun Shrestha; Jannik Aagerup; Gill Gyte; Alan Montgomery; Lelia Duley; Lisa Askie; iCOMP Collaboration

doi:10.1016/j.semperi.2023.151740

Optimizing cord management for each preterm baby - Challenges of collating individual participant data and recommendations for future collaborative research

Semin Perinatol. 2023 Jun;47(4):151740. doi: 10.1016/j.semperi.2023.151740. Epub 2023 Mar 20.

Authors

Affiliations

¹ Senior Research Fellow, NHMRC Clinical Trials Centre, University of Sydney, Australia. Electronic address: lene.seidler@sydney.edu.au.
² Human Mvt, Senior Evidence Analyst, NHMRC Clinical Trials Centre, University of Sydney, Australia.
³ Senior Evidence Analyst, NHMRC Clinical Trials Centre, University of Sydney, Australia.
⁴ Evidence Analyst, NHMRC Clinical Trials Centre, University of Sydney, Australia.
⁵ Post Doctoral Research Associate, NHMRC Clinical Trials Centre, University of Sydney, Australia.
⁶ BMedBiotech, Evidence Analyst, NHMRC Clinical Trials Centre, University of Sydney, Australia.
⁷ Post Doctoral Research Associate, NHMRC Clinical Trials Center, University of Sydney, Australia.
⁸ Research Administration Officer, NHMRC Clinical Trials Centre, University of Sydney, Australia.
⁹ Consumer Editor, Cochrane Pregnancy and Childbirth, University of Liverpool, UK.
¹⁰ Professor of Medical Statistics and Clinical Trials, Nottingham Clinical Trials Unit, University of Nottingham, UK.
¹¹ FRCOG, University of Nottingham, UK.
¹² MPH FAHMS FHEA, University of Sydney, Australia.

PMID: 37019711
DOI: 10.1016/j.semperi.2023.151740

Abstract

The optimal cord management strategy at birth for each preterm baby is still unknown, despite more than 100 randomized controlled trials (RCTs) undertaken on this question. To address this, we brought together all RCTs examining cord management strategies at preterm birth in the iCOMP (individual participant data on COrd Management at Preterm birth) Collaboration, to perform an individual participant data network meta-analysis. In this paper, we describe the trials and tribulations around obtaining individual participant data to resolve controversies around cord clamping, and we derive key recommendations for future collaborative research in perinatology. To reliably answer outstanding questions, future cord management research needs to be collaborative and coordinated, by aligning core protocol elements, ensuring quality and reporting standards are met, and carefully considering and reporting on vulnerable sub-populations. The iCOMP Collaboration is an example of the power of collaboration to address priority research questions, and ultimately improve neonatal outcomes worldwide.

Keywords: Clinical Trials; Evidence synthesis; Neonatology; Preterm birth; Umbilical cord clamping.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Constriction
Female
Humans
Infant
Infant, Newborn
Infant, Premature
Parturition
Pregnancy
Premature Birth*
Umbilical Cord