Study of the effect of delayed clamping of the umbilical cord on neonatal venous hematocrit values and clinical outcome at term

Abstract EN

Background: With few exceptions, the umbilical cord of every newborn is clamped and cut at birth, yet the optimal timing for this intervention remains controversial.

The umbilical cord is usually clamped immediately after birth.

There is no sound evidence to support this approach, which might deprive the newborn of some benefits such as an increase in iron storage .

Objectives : Our aim is to determine the effect of timing of cord clamping on neonatal venous hematocrit and clinical outcome in term newborns.

Methods: This study was a randomized, controlled trial performed in obstetric units , Bab –Sharria University Hospital, on 100 healthy full-term vaginally born neonates , to mothers with uneventful pregnancies.

Written parental consents were obtained .

Fifty newborns were randomly assigned to cord clamping within the first 15 seconds (group 1), and 50 newborns at 2 minutes after birth (group 2).

The infants' venous hematocrit values were measured at 6 hours and 48 hrs of age.

Results: Neonatal hematocrit values at 6 hrs of life were (53 ± 1.1 % vs 56 ± 1.2% with p =0.188) and at 48 hrs of life were (47± 0.9% vs 52 ± 1.0 %) among group 1 vs group 2 respectively (p=0.005).

Statistical analyses were performed, and results were equivalent among the 2 groups because the hematocrit increase in neonates with delayed clamping was within the physiologic range.

This was also true for neonatal polycythemia (4.0 % vs 6.0 %) respectively (p = 0.902).

Conclusion: Delayed cord clamping does not lead to statistically significant difference in the hematocrit level of the neonate or neonatal polycythemia.

Further trials should examine the effect of delaying cord clamping for a longer period of time to determine whether these variations result in more clinically significant results.