Effect of timing of cord clamping on neonatal venous hematocrit and clinical outcome at term hospital based randomized control trial

Abstract

The study was conducted at the department of Obstetrics and Gynecology at Jawaharlal Nehru Medical College, Aligarh India from June 2008 to October 2010. 200 mothers were selected for the study and informed consent using a predesigned proforma. The subjects were divided into 4 groups of 50 each wherein the umbilical cord was clamped at 15 seconds, 30 seconds, 1 minute and 2 minutes respectively. The neonatal venous hematocrit and clinical outcome was assessed. The primary objective was to study the effect of timing of cord clamping on neonatal venous hematocrit at 6 and 24 hours of life. The other neonatal parameters assessed were blood glucose at 6 and 24 hours, serum calcium at 6 hours, serum total bilirubin at 24 hours, oxygen saturation, temperature and duration of NICU stay. The maternal parameters studied were pre and post delivery hemoglobin, pre and post delivery hematocrit and blood loss during delivery. Data was analyzed using statistical package for social service software-SPSS version 11.5. A p value of less than 0.05 was considered statistically significant. Our study showed a rising trend in neonatal hematocrit values with progressive delay in clamping of the umbilical cord. A high indience of anemia was seen among the newborns if the cord was clamped at 15 seconds. No infant was reported to have anemia if the cord was clamped at 2 minutes. Ony asymptomatic polycythemia was seen in this category. A beneficial effect of delayed cord clamping on neonatal hematocrit at both 1 and 2 minutes but it is significantly higher at 2 minute clamping group as compared to 1 minute clamping group.

A Quasi-Experimental Study to Assess Consequences of Early Versus Delay Umbilical Cord Clamping on Maternal and Neonatal Outcomes in Beni-Suef city

“…[36] Though enhancements in hemoglobin concentrations are more passing, newborns delivery ECC have decreased iron stores and are twice as likely to be iron deficient at three to six months of age in his study aboutΑ quality improvement initiative for delayed umbilical cord clamping in very-low-birth-weight infants at Department of Neonatology, Christiаna Care Health System USΑ. In agreement with Ishtiaq & Bano (2013) who found that the prevalence of neonatal anemia at six hrs was more when the cord was clamped early. In group (1), 8% neonates were set up anemic with no incidence of polycythemia.…”

“…Which the study sample was divided into 4 groups of 50 each wherein the umbilical cord was clamped at 15 seconds, 30 seconds, 1 minute and 2 minutes respectively. [37] Polycythemiа or a hemаtocrit level of >65% at birth & after 24 hours among early & late group was lower in ECC but higher among the late cord clamping group compared to early cord clamping, this result supported by Ishtiaq & Bano (2013) who stated that,in group 4 polycythemia occurred in 6% of cases and no found anemic…”

Neonatal Outcomes In Cord Clamping And Its Association With Hematological Parameters

“…Intervention to reduce anaemia during first six months of life 9 . Others realize that blood overload from delayed cord clamping can produce respiratory distress, polycythemia and jaundice 10,11 . while with early cord clamping maternal blood loss following birth can be reduced significantly 12 .…”