Abstract
BackgroundDelayed umbilical cord clamping is associated with greater haemoglobin concentration and iron storage between 3 and 6 months of life and with less need of blood transfusion and lower incidence of neonatal hypotension compared to early umbilical cord clamping.MethodsThe aim was to test the hypothesis that delayed cord clamping is better than early cord clamping in term infants born by elective caesarean section. Group A was subjected to immediate cord clamping while in the Group B, the umbilical cord was clamped 1 min after birth. Primary aim was revealed the difference in pre-ductal saturation between two groups while secondary aim was investigating the difference in HR, Ht, bilirubin and glycaemia. Pre-ductal SpO2 and HR were recorded at 5 and 10 min after birth, T was analysed 10 min after birth, glycaemia was revealed at 120 min while Ht and bilirubin were collected at 72 h.Results132 newborns were enrolled in the study and allocated in ratio 1:1 to group A or B. Delayed cord clamping did not improve SpO2, HR and T values compared to immediate cord clamping (p > 0,05). However, Group B showed greater haematocrit and bilirubin values at 72 h compared to Group A (56,71 ± 6663 vs 51,56 ± 6929; p < 0,05 and 8,54 ± 2,90 vs 7,06 ± 2,76; p < 0,05). Glycaemia value did not differ between two groups (p > 0,05).ConclusionsGroup B did not reveal any differences in SpO2, HR, T and glycaemia compared to Group A. Group B showed greater values of haematocrit and bilirubin but without need of phototherapy.Trial registrationUmbilical Cord Clamping: What Are the Benefits; NCT03878602. Registered 18 March 2019 retrospectively registered.
Highlights
Delayed umbilical cord clamping is associated with greater haemoglobin concentration and iron storage between 3 and 6 months of life and with less need of blood transfusion and lower incidence of neonatal hypotension compared to early umbilical cord clamping
delayed cord clamping (DCC) is better than immediate umbilical cord clamping (ICC) because it is associated with a great haemoglobin concentration in the newborns and best iron storage between 3 and 6 months of life and less incidence of transfusion and neonatal hypotension [6,7,8,9]
In a recent randomized study conducted in Nepal on 540 newborns, birth by eutocic delivery at term of gestational age, showed that DCC after 3 min of life is correlated with a better haemoglobin level and less incidence of anaemia at 8 months of life [10]
Summary
Delayed umbilical cord clamping is associated with greater haemoglobin concentration and iron storage between 3 and 6 months of life and with less need of blood transfusion and lower incidence of neonatal hypotension compared to early umbilical cord clamping. It was revealed that CS was associated with an increased placental residual blood volume and a decreased level of iron-related haematological indices including haematocrit, haemoglobin, and erythrocyte in both cord and peripheral blood in term neonates at 3 or 6 h of life. This difference on placental transfusion could be caused to a weaker transfusion force and a shorter transfusion period during CS due to ICC. Despite the evidence of beneficial effects for umbilical cord delay after eutocic delivery, this practice has not yet been evaluated after ECS
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