Timing of umbilical cord-clamping and infant anaemia: the role of maternal anaemia

Blouin, Brittany; Penny, Mary E.; Maheu‐Giroux, Mathieu; Casapía, Martín; Aguilar, Eder; Silva, Hermánn; Creed-Kanashiro, Hilary; Joseph, Serene A.; Gagnon, Anita J.; Rahme, Elham; Gyorkos, Theresa W.

doi:10.1179/2046905512y.0000000036

Cited by 19 publications

(11 citation statements)

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“…A questionnaire, which included questions on socio-demographic and health information about the child and family, was then administered by the RA during a household interview with that parent who was the primary caregiver. The questionnaire was adapted from previous studies [8] , [21] – [23] , but included additional questions related to child nutrition. These included history and duration of breastfeeding, and first introduction of liquids and solid foods.…”

Section: Methodsmentioning

confidence: 99%

Risk Factors Associated with Malnutrition in One-Year-Old Children Living in the Peruvian Amazon

et al. 2014

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BackgroundChildren under two years of age are in the most critical window for growth and development. As mobility increases, this time period also coincides with first exposure to soil-transmitted helminth (STH) infections in tropical and sub-tropical environments. The association between malnutrition and STH infection, however, has been understudied in this vulnerable age group.Methodology/Principal FindingsA nested cross-sectional survey was conducted in 12 and 13-month old children participating in a deworming trial in Iquitos, an STH-endemic area of the Peruvian Amazon. An extensive socio-demo-epi questionnaire was administered to the child's parent. Length and weight were measured, and the Bayley Scales of Infant and Toddler Development were administered to measure cognition, language, and fine motor development. Stool specimens were collected to determine the presence of STH. The association between malnutrition (i.e. stunting and underweight) and STH infection, and other child, maternal, and household characteristics, was analyzed using multivariable Poisson regression. A total of 1760 children were recruited between September 2011 and June 2012. Baseline data showed a prevalence of stunting and underweight of 24.2% and 8.6%, respectively. In a subgroup of 880 randomly-allocated children whose specimens were analyzed by the Kato-Katz method, the prevalence of any STH infection was 14.5%. Risk factors for stunting in these 880 children included infection with at least one STH species (aRR = 1.37; 95% CI 1.01, 1.86) and a lower development score (aRR = 0.97; 95% CI: 0.95, 0.99). A lower development score was also a significant risk factor for underweight (aRR = 0.92; 95% CI: 0.89, 0.95).ConclusionsThe high prevalence of malnutrition, particularly stunting, and its association with STH infection and lower developmental attainment in early preschool-age children is of concern. Emphasis should be placed on determining the most cost-effective, integrated interventions to reduce disease and malnutrition burdens in this vulnerable age group.

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Section: Methodsmentioning

confidence: 99%

Risk Factors Associated with Malnutrition in One-Year-Old Children Living in the Peruvian Amazon

et al. 2014

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“…At face value, the results support the efficacy of the project in promoting DCC, but changing practice from waiting to the cord stops pulsating to clamping at 3 min deserves some reflective assessment about the project design including implications for future practice change interventions and cultural influences on behaviours. Having a policy and procedure in place has been reported as significantly supporting adoption of new practice (Blouin et al 2013) and having institutional support promotes the effectiveness of maternal and child health services (Rao 2012). It is possible that the NICE Foundation policy and procedure influenced the uptake of DCC as much as the workshop although we do not have evidence to support this statement.…”

Section: Discussionmentioning

confidence: 80%

Midwives in India: a delayed cord clamping intervention using simulation

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Prater

et al. 2016

International Nursing Review

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Changing institutional policy may have limitations without first considering normative practice. Using simulation combined with institutional health policy appears to result in significant uptake of practice change. Qualitative studies exploring the interconnections between cultural norms and decision making may be informative about promoting practice change particularly in this setting. Upscaling midwifery has been recommended to improve maternal and child health in India.

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“…6,10,11 One of the more widely accepted of these consequences is the increase in placenta-to-infant blood volume transfer, supplying an additional 30 to 75 mg of iron at delivery. 12 The concerns about delayed cord clamping include the possibility of polycythemia, hyperviscosity, hyperbilirubinemia, transient tachypnea of the newborn, delay in resuscitation, hypothermia, and a possible risk of intraventricular hemorrhage. 11 On the other hand, several studies have reported that parturition features a strong oxidative stress for both mother and neonate, implying an increased production of free radicals that must be controlled by their antioxidant systems.…”

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The Timing of Cord Clamping and Oxidative Stress in Term Newborns

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WHAT'S KNOWN ON THIS SUBJECT: Clamping and cutting of the umbilical cord at birth is the most prevalent of all operations; however, the optimal timing of cord clamping is still a controversial issue, with different timings offering advantages and disadvantages.WHAT THIS STUDY ADDS: Our findings suggest a protective effect of late cord clamping, increasing the antioxidant capacity and decreasing the inflammatory-mediated effects induced during delivery of term neonates. abstract BACKGROUND: Clamping and cutting of the umbilical cord is the most prevalent of all operations, but the optimal timing of cord clamping is controversial, with different timings offering advantages and disadvantages. This study, for the first time, compares the influence of early and late cord clamping in correlation with oxidative stress and inflammation signaling, Because cord clamping timing may have a significant influence on placenta-to-infant blood transfer, thereby modifying oxygenation of maternal and fetal tissues, and on the transfer of inflammatory mediators throughout the placenta. METHODS:Sixty-four pregnant subjects were selected at the Gynecology and Obstetrics Services Department of the Clinico San Cecilio Hospital, Granada, Spain, based on disease-free women who experienced a normal course of pregnancy and a spontaneous, vaginal, single delivery. Half of the subjects had deliveries with early-clamped newborn infants (at 10 s), and the other half had late-clamped deliveries (at 2 min).RESULTS: Erythrocyte catalase activity was significantly greater in the late-clamped group than in the early-clamped group (P , .01 for the umbilical vein and P , .001 for the artery). The values for superoxide dismutase, total antioxidant status, and soluble tumor necrosis factor receptor II were all significantly higher in the late-clamped group compared with the early-clamped group (P , .01, P , .001, and P , .001, respectively). CONCLUSIONS:The results suggest a beneficial effect of late cord clamping, produced by an increase in antioxidant capacity and moderation of the inflammatory-mediated effects induced during delivery of term neonates. Clamping and cutting of the umbilical cord at birth is by far the oldest and most prevalent operation in humans. Although the World Health Organization stated that late cord clamping or not clamping at all represents a more physiologic method of neonatal care, 1 the optimal timing of cord clamping has been a controversial issue for decades, and there is still debate on the issue. 2 The current obstetric approach in Western medicine is to clamp the cord within the first 10 to 15 seconds after birth. 3 However, there has been no sound evidence in favor of this approach in comparison with the ageold practice of clamping the cord between 1 and 3 minutes after birth. 4 Earlier physiologic studies have shown that, of the total blood volume in combined fetal-placental circulation at full gestation, ∼25% to 60% (54-160 mL) is found in placental circulation, and as many as 60% of the fetal red blood cells are f...

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Timing of umbilical cord-clamping and infant anaemia: the role of maternal anaemia

Abstract: The study contributes additional evidence in support of delayed cord-clamping. This intervention is likely to have most public health impact in areas with a high prevalence of anaemia during pregnancy.

Cited by 19 publications

References 19 publications

Risk Factors Associated with Malnutrition in One-Year-Old Children Living in the Peruvian Amazon

Risk Factors Associated with Malnutrition in One-Year-Old Children Living in the Peruvian Amazon

Midwives in India: a delayed cord clamping intervention using simulation

The Timing of Cord Clamping and Oxidative Stress in Term Newborns

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