The Effect of Different Timings of Delayed Cord Clamping of Term Infants on Maternal and Newborn Outcomes in Normal Vaginal Deliveries

Abstract

Background and objectiveDelayed cord clamping (DCC) has proven to be an ideal approach to reduce iron deficiency anemia; however, different timings of DCC relative to the birth outcome lead to conflicting results. The present study was conducted to determine the effects of different timings of DCC on the maternal and neonatal outcomes in normal vaginal deliveries at term. MethodsThis was an interventional study on neonates born at term without complications to mothers with uneventful pregnancies in the labor unit of a district hospital in Odisha, India. A total of 147 women were randomized to three intervention groups: DCC at one minute, DCC at two minutes, and DCC at three minutes. Hemoglobin and bilirubin levels, maternal blood loss, the timing of the third stage of labor, oxytocin use, and birth weight of the neonates were measured as the outcomes of different timings of DCC. ResultsAt 24-48 hours of age, hemoglobin and bilirubin levels of the neonates were significantly higher with DCC at three minutes compared to DCC at one and two minutes. However, there were no significant differences among the three groups in terms of the need for phototherapy. The duration of the third stage of labor was significantly longer with DCC at three minutes. Maternal blood loss, oxytocin use, and birth weight of the neonates were not significantly associated with the timing of DCC. ConclusionBased on our findings, waiting to clamp the umbilical cord until three minutes can effectively reduce the incidence of iron deficiency anemia in newborns.

Effects of delayed cord clamping at different time intervals in late preterm and term neonates: a randomized controlled trial

“…A recent interventional study comparing the effects of DCC at 1, 2, and 3 min in vaginally-delivered term neonates documented significantly higher mean hemoglobin and TSB levels at 3 min compared to 1 and 2 min DCC. However, the need for phototherapy was similar and there was no difference in maternal blood loss [ 26 ]. The Australian Placental Transfusion Study that enrolled 1566 preterm infants of GA < 30 weeks documented an increase in hematocrit by 2.7 percentage points (95% CI, 1.9 to 3.5) in the DCC group compared to ECC.…”

“…We did not find any higher incidence of PPH or maternal blood transfusion. Though there were concerns in earlier ECC vs DCC studies, no difference has been reported by studies comparing various time intervals of DCC [ 20 , 21 , 26 ].…”