Timing of Cord Clamping and it's Effect on Haematocrit and Clinical Outcome of Neonate

Abstract

Background: It is the usual practice to clamp umbilical cord immediately after birth.There is no sound evidence to support this approach, which might deprive the newbornof some benefits, such an increase in iron storage.Objectives: The study was done to determine the effect of timing of cord clamping onneonatal venous haemoglobin and haematocrit values and clinical outcome withinneonatal period.Methodology: This was a randomized, controlled trial performed in Obstetrical Unitwith support of Neonatal Unit of Paediatrics and Department of Clinical Pathology ofBSMMU on neonates born at term without complication to mothers with uneventfulpregnancies. After obtaining written parental consent newborns were randomly assignedto cord clamping within first 15 seconds (group-I Early Cord Clamping, ECC), ataround 1 minute (group-II Late Cord Clamping, LCC) after birth. The infant's venoushaemoglobin and haematocrit values were measured at 6 hours and 24 to 48 hoursafter birth.Results: 130 mothers were selected for study purpose. Finally 98 were analyzed, 50in early cord clamping group and 48 in late cord clamping group. Mean venoushaemoglobin and haematocrit values at around 6 and 24 to 48 hours of life weremeasured. Results were within physiological limit but difference were significantbetween 2 study groups. The prevalence of anaemia (Hb <14 gm%) was notsignificantly higher in group-I than group-II but relatively more newborns were anaemicin group-I. There was no significant difference in other neonatal outcomes and maternalpostpartum events.Conclusions: Delayed cord clamping at birth increases neonatal venous haemoglobinand haematocrit values within a physiologic range. No harmful effects were observedamong both groups. Furthermore this intervention seems to reduce the incidence ofneonatal anemia. This practice has been shown to be safe and should be practicedto increase neonatal haemoglobin and haematocrit values at birth.Key words: Early cord clamping (ECC); late cord clamping (LCC).DOI: 10.3329/bjch.v33i1.5670Bangladesh Journal of Child Health 2009; Vol.33(1): 16-21