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).

Background : Delayed cord clamping (DCC) occurs in most preterm births. Objective : Evaluate the association of DCC with acute kidney injury (AKI) and two-year kidney outcomes. Methods : Secondary analysis of the Preterm Erythropoietin Neuroprotection Trial of neonates born 24 0/7 to 27 6/7 weeks' gestation. AKI and two year kidney outcomes were compared in neonates with DCC (≥30 seconds after delivery) to those with early cord clamping (ECC) (<30 seconds after delivery). Results : 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 times increased adjusted odds of eGFR <90 mL/min/1.73m 2 . No significant associations were noted between DCC and albuminuria or elevated BP. Conclusions : DCC was not associated with decreased neonatal AKI, but was associated with higher adjusted odds of eGFR <90 mL/min/1.73m 2 at two years.