Abstract

Background and objectiveDelayed cord clamping (DCC) has proven to be an ideal approach to reduce iron deficiency anemia; however, different timings of DCC relative to the birth outcome lead to conflicting results. The present study was conducted to determine the effects of different timings of DCC on the maternal and neonatal outcomes in normal vaginal deliveries at term.MethodsThis was an interventional study on neonates born at term without complications to mothers with uneventful pregnancies in the labor unit of a district hospital in Odisha, India. A total of 147 women were randomized to three intervention groups: DCC at one minute, DCC at two minutes, and DCC at three minutes. Hemoglobin and bilirubin levels, maternal blood loss, the timing of the third stage of labor, oxytocin use, and birth weight of the neonates were measured as the outcomes of different timings of DCC.ResultsAt 24-48 hours of age, hemoglobin and bilirubin levels of the neonates were significantly higher with DCC at three minutes compared to DCC at one and two minutes. However, there were no significant differences among the three groups in terms of the need for phototherapy. The duration of the third stage of labor was significantly longer with DCC at three minutes. Maternal blood loss, oxytocin use, and birth weight of the neonates were not significantly associated with the timing of DCC.ConclusionBased on our findings, waiting to clamp the umbilical cord until three minutes can effectively reduce the incidence of iron deficiency anemia in newborns.

Highlights

  • Anemia is a major health concern worldwide, and it can lead to morbidity and mortality in young children

  • Hemoglobin and bilirubin levels, maternal blood loss, the timing of the third stage of labor, oxytocin use, and birth weight of the neonates were measured as the outcomes of different timings of Delayed cord clamping (DCC)

  • At 24-48 hours of age, hemoglobin and bilirubin levels of the neonates were significantly higher with DCC at three minutes compared to DCC at one and two minutes

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Summary

Introduction

Anemia is a major health concern worldwide, and it can lead to morbidity and mortality in young children. Around 1.6 billion people are anemic, and the majority of the affected individuals are young school-aged children [1,2]. In Asia, India is severely affected by this condition, with around 90 million people suffering from anemia, of which 70% are children in the age group of 6-59 months [1]. Delayed cord clamping (DCC) has proven to be an effective approach to overcome this issue; variations in the timing of DCC have limited its application in the clinical setting [4,5,6,7]. Delayed cord clamping (DCC) has proven to be an ideal approach to reduce iron deficiency anemia; different timings of DCC relative to the birth outcome lead to conflicting results. The present study was conducted to determine the effects of different timings of DCC on the maternal and neonatal outcomes in normal vaginal deliveries at term

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