Effect of delayed cord clamping on hemoglobin level of newborns.

Abstract

To the Editor: Anemia is a common disorder. The prevalence of iron deficiency anemia is highest among children and thus, its prevention during infancy is a priority. The first step to reduce anemia can be taken at the time of birth. Delayed cord clamping could be a cost-effective intervention to improve the iron status of infants by enhancing their red cell mass [1]. It allows time for the transfer of fetal blood in the placenta to the infant at the time of birth. “Placental transfusion” can provide the infant with an additional 30 % more blood volume and up to 60 % more red blood cells, the only oxygen-carrying component in the body. Both are lost with immediate cord clamping [2, 3]. A study was conducted among 61 term infants30 in Group I (cord clamped within 15 s of birth) and 31 in Group II (cord clamped at 3 min of birth or immediately after cessation of pulsation). Hemoglobin level was checked from cord blood and after 24 h by heel prick method. The mean hemoglobin level of subjects at birth was 17.15±1.56 and 19.97±1.51 in Group I and Group II respectively with ‘t’ value of 5.644, (p<0.000) (Table 1). The mean hemoglobin level at 24 h was 16.97±1.13 and 19.59±1.39 in Group I and Group II respectively with ‘t’ value 7.599, (p<0.000) (Table 2). Shirvani et al. conducted a study on effect of umbilical cord clamp timing on newborn’s iron status among hundred motherinfant pairs, divided into two groups: early cord clamp time [within 15 s (n =70)] or delayed cord clamp time [15 s after delivery (n =30)] [4]. The mean infant hemoglobin (Hgb; 16.08 g/dL vs. 14.5 g/dL; P<0.001) levels were significantly higher in the delayed clamping group. The Pan American Health Organization released new recommendations favoring delayed cord clamping over immediate cord clamping. This intervention has not only been proven effective, but is cost-free, making it a particularly appropriate and sustainable intervention for low-resource areas of the world.