Abstract
AbstractThe aim of this study was to compare the effects of delayed cord clamping (DCC) and early cord clamping (ECC) on venous hematocrit (htc) and clinical outcomes in infants of diabetic mothers (IDMs). This prospective randomized study included 157 term IDMs. The umbilical cords of these infants were clamped at least 60 seconds in group I (DCC group, n = 79) and as soon as possible after birth in group II (ECC group, n = 78). The two groups were compared regarding neonatal venous htc levels, hypoglycemia rates, jaundice requiring phototherapy, respiratory distress, and admission to the neonatal intensive care unit (NICU). Hematocrit levels were significantly higher in the DCC group, both at 6 and 24 hours postnatally (p = 0.039 and 0.01), respectively. Polycythemia frequency was higher in DCC than the ECC group, but no patient in either group needed partial exchange transfusion (PET). Rates of jaundice were significantly higher in the DCC group (p = 0.028), but there was no significant difference between the two groups regarding jaundice requiring phototherapy (p = 0.681). There were no differences between the groups regarding hypoglycemia rates, need for glucose infusion, or respiratory distress. The incidence of admission to NICU was lower in the DCC group (p = 0.005). Early clamping was a significant predictor for increased risk of NICU admission. DCC increased polycythemia and jaundice rates but did not increase the need for PET or phototherapy. Also, DCC reduced the severity of respiratory distress and the subsequent need for NICU admission.
Highlights
The optimal timing of umbilical cord clamping remains controversial.[1]
Our results showed that Delayed cord clamping (DCC) in infants of diabetic mothers (IDMs) increased the incidence of polycythemia but without the need for partial exchange transfusion (PET)
Our study revealed that respiratory distress incidence was higher in DCC than early cord clamping (ECC) group, but without significant difference
Summary
The optimal timing of umbilical cord clamping remains controversial.[1] Umbilical cord clamping can be done immediately after birth or be delayed. Delayed cord clamping (DCC) can be performed by clamping the cord from 30 seconds to 3 minutes after birth when cord pulsation has ceased, and the infant has started crying.[2,3,4]. It has been shown that DCC can increase placental transfusion, leading to an increase in neonatal blood volume at birth of approximately 30%. This may result in an increase in iron stores, thereby decreasing the risk of anemia.[5] DCC, might increase the risk of polycythemia, jaundice, the need for phototherapy, and respiratory distress, especially in certain risk groups of infants.[6] DCC is associated with received December 8, 2020 accepted after revision February 18, 2021
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