Delayed cord clamping in term large‐for‐gestational age infants: A prospective randomised study

Abstract

Aim To compare the post‐natal effects of delayed cord clamping (DCC) and early cord clamping (ECC) in term large‐for‐gestational age (LGA) infants. Methods This prospective randomised study included 51 term LGA infants. The umbilical cords of these infants were clamped at 15 s in group 1 (ECC group (n = 26)) and at 60 s in group 2 (DCC group (n = 25)). Data for Apgar scores, cord blood, pH and lactate values, second haematocrit, 24th bilirubin levels, duration of hospital stay and admission to the neonatal intensive care unit (NICU) were recorded. Results The demographic characteristics of the infants in the study group were not significantly different. No statistically significant difference was observed in the post‐natal haematocrit and bilirubin levels between the groups. Six infants (group 1, n = 3; group 2, n = 3) were diagnosed with polycythaemia (P = 0.79); however, these infants remained asymptomatic, and no treatment was required. One infant in each group developed hyperbilirubinemia, which required phototherapy (P = 1.00). The infant with hyperbilirubinemia in the DCC group presented with asymptomatic polycythaemia. Three neonates in the DCC group required admission to the NICU for transient tachypnoea. Conclusions No significant increase in the rate of post‐natal complications of DCC in term LGA infants was observed in the study. However, before recommending DCC on a routine basis, studies with a larger sample size and long‐term follow‐up are required to elucidate the risks and benefits of DCC in this group of infants.

Delayed Cord Clamping in Infants of Diabetic Mothers: Laboratory and Clinical Outcomes

“…As a facilitator of adaptation, DCC decreased the rates of NICU admission by 18.1% in IDMs. In contrast to our results, a previous study reported that respiratory distress was not observed in the ECC group; however, three infants in the DCC group were admitted to the NICU due to transient tachypnea, but this difference was not significant, 6 the relatively smaller sample included in their study may explain this discrepancy.…”

“…In contrast to the results of a previous study conducted to detect the effects of DCC on LGA, which reported that there was no statistically significant difference between the DCC and ECC groups in terms of htc levels measured at the second hour of age. 6 The incidence of polycythemia has been demonstrated to be between 10 and 40% in IDM. 20 A previous study evaluating DCC in term newborns indicated that DCC increases htc levels in term infants but does not change polycythemia incidence.…”

“…Our results are in agreement with two previous studies that showed that DCC does not increase the need for phototherapy. 6,13 However, Chaparro et al demonstrated that the need for phototherapy was higher in infants with DCC than in infants with ECC. 22 In our study, rates of hypoglycemia, hypoglycemia requiring glucose infusion, and hypocalcemia were all higher in the ECC group than in the DCC group, but there was also no statistically significant difference.…”

Lalana Newborn Resuscitation

“…not generate adequate intrapulmonary pressure but also proves potentially harmful as entire tidal volume will only enter previously aerated regions due to the much lower airway resistance predisposes to lung injury with overexpansion and intermittent collapse of alveoli causing ventilation perfusion (V/Q) mismatch, persistent pulmonary hypertension and bradycardia that further perpetuates hypoxia with delay in onset of breathing [29,30,35,37]. Thus continuous distending airway pressure by sustained oxygen inflation is the key to mitigating hypoxiainduced inhibition of breathing [53,54].…”

2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 8. Neonatal resuscitation

“…A DCC of ≥ 30 seconds is reportedly associated with higher levels of hematocrit after birth and improved levels of iron during infancy. [19][20][21][22][23][24][25][26][27][28][29][30][31] In preterm newborns who do not require resuscitation, DCC may be effective as it lowers the need for blood pressure management and blood transfusion and improves survival (Class IIa, Level B-R). [32][33][34][35][36][37][38][39] However, there is little evidence supporting early or DCC in term or preterm newborns who require resuscitation at birth (Class IIb, Level C-EO).…”