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

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.
Competing Interests: Disclosure All authors are secretariat members of the iCOMP Collaboration. There are no financial conflicts of interest to disclose. The iCOMP Collaboration is funded by a National Health and Medical Research Council (NHMRC) Project Grant (GNT1163585). ALS is funded by an NHMRC Investigator grant (GNT2009432).
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