726 - The SAVE Study: Neurodevelopment at 4 Months After Randomized Intact Cord Resuscitation

Publication Number: 2708.726

Maria Wilander, Lund University, Halmstad, Hallands Lan, Sweden; Katarina Ekelöf, Lund University, Halmstad, Hallands Lan, Sweden; Li Thies-Lagergren, Lund University, Lund, Skane Lan, Sweden; Ola Andersson, Lund University, Halmstad, Hallands Lan, Sweden

Background: Delayed cord clamping has been associated with indications of improved neurodevelopment in healthy infants. Intact cord resuscitation (ICR) expands on this principle by providing respiratory support while maintaining placental circulation at birth, and may thereby influence early neurodevelopment.

Objective: To evaluate neurodevelopmental outcomes at 4 months in infants randomized to ICR versus standard resuscitation in the SAVE multicenter trial, using ASQ-3

Design/Methods: Parents of 563 infants were invited to complete ASQ-3 questionnaires, which assess five key neurodevelopmental domains: communication, gross motor, fine motor, problem solving, and personal-social skills. Each domain has a maximum possible score of 60 points. Median scores and proportions of infants scoring below 2 standard deviations (SD), the threshold indicating need for further clinical evaluation, were compared between groups.

Results: Completed questionnaires were received from 369 infants (response rate 65.4%), including 202 in the ICR group and 167 controls. The median communication score was higher in the ICR group at 55 (range 50-55) compared to 50 (range 45-55) in controls (p = 0.04). No significant differences were observed between groups in the proportions scoring below the 2 SD cutoff across all domains.

Conclusion(s): Infants randomized to ICR showed a trend towards higher median communication scores at 4 months. The similar proportions scoring below the 2 SD threshold suggest comparable risk profiles for developmental delay between groups. These findings encourage further research into the neurodevelopmental effects of ICR.

Median ASQ-3 Domain Scores at 4 Months of age
Median (interquartile range) scores for each neurodevelopmental domain at 4 months in infants randomized to intact cord resuscitation versus control groups, with corresponding p-values for group comparisons

Proportion of infants with ASQ score < 2 SD
Comparison of the proportion of infants in the intact cord resuscitation and control group scoring below 2 SD in each neurodevelopmental domain at 4 months. Bars represent group proportions for each domain