Factors associated with delayed umbilical cord clamping in public health facilities in Debremarkos town, northwest Ethiopia

Abstract

Background Delayed cord clamping is a proven intervention to improve both maternal and neonatal health and nutrition. World Health Organization recommends not clamping the umbilical cord before 1 minute of delivery. However, little is known about the timing of umbilical cord clamping, and associated factors in Ethiopia. Objective To assess the timing of umbilical cord clamping and associated factors among women who gave birth at public health institutions in Debremarkos town, 2022/23. Methods A facility-based cross-sectional study was conducted from December 01, 2022, to January 30, 2023, among women selected using systematic random sampling. Data was collected through observation and review of medical records using a checklist. The data was entered to Epi-data version 4.6.0.4 and analyzed by STATA 14. Descriptive statistics, bivariable and multivariable logistic regression models were fitted. Result A study of 388(91.73% response rate) women-newborn pairs found that 206(53.09%) newborns received delayed umbilical cord clamping, with mean and median clamping times of 67.87 ± 39.86 SD and 60s, respectively. In the multivariable analysis, giving birth at the hospital (AOR = 2.47, 95% CI: 1.21-5.03), attended by medical interns (AOR = 2.47, 95% CI: 1.29-5.41), receiving uterotonic for AMTSL at or after 60 seconds of giving birth (AOR = 10.36, 95% CI: 6.02-17.84), Rh-negative mothers (AOR = 3.91, 95% CI: 1.40-10.95), and multiparity (AOR = 0.54, 95% CI: 0.32-0.93) were significantly associated with delayed umbilical cord clamp. Conclusion In this study, half of the newborns had delayed umbilical cord clamping. However, the result is still unsatisfactory, as the recommendations for delayed cord clamping extend to all newborns who do not require intensive care. Therefore, considering the proven benefit of delayed umbilical cord clamping, obstetric care providers should adhere to clinical guidelines for this proven intervention.