Early Versus Delayed Umbilical Cord Clamping in Preterm Births

Abstract

Background: Preterm infants are at a great risk for both cognitive and motor delay. Hypovolemia secondary to immediate cord clamping, may be disruptive to the developing brain resulting in subsequent motor delay. Objective: The aim of this work is to compare early versus delayed cord clamping in cases of preterm birth. Patients and Methods: This is a prospective randomized controlled study which was performed at Al-Azhar University Maternity Hospital from July 2018 to February 2019. It included 100 pregnant patients. They were divided into two equal groups: Group I with early cord clamping (ECC). Group II with delayed cord clamping (DCC). Results: In our study the hematocrit on day 1 was also significantly higher in the DCC group (5.2%+50.8 ±vs. 58.5 ±5.1 %, p value 0.00). The DCC group required significantly longer duration of phototherapy (55.3±40.0 h vs. 36.7±32.6 h, p value 0.016) and had a trend towards higher risk of polycythemia probably due to the higher hemoglobin and bilirubin pool in those babies, however the incidence of significant jaundice was not different. In this study, there was no statistically significant difference in blood pressure between neonates of both groups of ECC and DCC. Our study found that 24% of the group underwent delayed cord clamping needed blood transfusion versus 70% of infants of the group of the immediate cord clamping. Conclusion: Delayed cord clamping (DCC) (more than 30 seconds) in preterm births is associated with higher Hb, hematocrit and less need for blood transfusion compared to immediate cord clamping.