Effect of timing of cord clamping (early vs delayed) on hemoglobin level among newborns: an Indian study

Bikramjit S. Jafra; Sunil K. Mehendiratta; Pooja R. Jafra; Anudeep Jafra

doi:10.18203/2320-1770.ijrcog20231553

Authors

Bikramjit S. Jafra Department of Pediatrics, Gian Sagar Medical College and Hospital, Rajpura, Punjab, India
Sunil K. Mehendiratta Department of Pediatrics and Neonatology, Venkateshwar Hospital, Dwarka, New Delhi, India
Pooja R. Jafra Department of Obstetrics and Gynaecology, Gian Sagar Medical College and Hospital, Rajpura, Punjab, India
Anudeep Jafra Department of Anaesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20231553

Keywords:

Anaemia, Cord clamping, Hemoglobin levels, Newborn

Abstract

Background: Aim of the current study was to evaluate effect of delayed cord clamping on hemoglobin level among newborns and look for any adverse effects following delayed cord clamping.

Methods: Total 60 newborns were enrolled in the study and were randomly allocated to either control (early cord clamping 15 secs) and cases (delayed cord clamping 3 mins). Samples were collected in labor room, during birth to check the hemoglobin, billirubin and hematocrit levels in two groups. Follow up data were collected in postnatal ward, 24 hours after birth to estimate hemoglobin, hematocrit and billirubin levels and infants were assessed for the presence of respiratory distress.

Results: Hb levels among cases were significantly higher compared to controls at birth. The mean Hb at birth among controls was 14.90±1.28 g/dl and among cases was 16.06±2.37 g/dl (p value 0.023). Hb levels among cases were significantly higher compared to controls at 24 hours. The mean Hb at 24 hours among controls was 16.16±1.70 g/dl and among cases was 19.28±2.16 g/dl (p value <0.001).

Conclusions: Hemoglobin and hematocrit levels were significantly increased at birth as well as at 24 hours of age in delayed compared to early clamping group with no significant adverse effects seen in the group with delayed clamping.

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References

World Health Organization. United Nations Children’s Fund, United Nations University. Iron deficiency anaemia Assessment, prevention, and control. A guide for programme managers. Geneva: World Health Organization; 2001. Available at: http://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdf. Accessed 18 June 2014.

Rheenen PV, Brabin BJ. A practical approach to timing cord clamping in resource poor settings. BMJ. 2006;333(7575):954-8.

Rheenen PV, Moor LD, Eschbach S, Grooth HD, Brabin B. Delayed cord clamping and haemoglobin levels in infancy: a randomised controlled trial in term babies. Trop Med Int Health. 2007;12(5):603-16.

American Academy of Pediatrics Subcommittee on Hyperbilirubinemia: Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004;114(1):297-316.

World Health Organization. Maternal and newborn health/safe motherhood, care of the umbilical cord: a review of the evidence. Geneva, Switzerland: Department of Reproductive Health and Research, World Health Organization, 1998. Available at: https://www.bing.com/search?q=Maternal+and+newborn+health%2Fsafe+motherhood%2C+care+of+the+umbilical+cord%3A+a+review+of+the+evidence&cvid=8192831518904fd2bb84012199f2d3ce&aqs=edge.0.69i59.767j0j4&FORM=ANAB01&PC=U531. Accessed 10 Jan 2023.

Dash MB, Murali R, Rajarajeswari S. Effect of delayed cord clamping on hemoglobin level among newborns in Rajiv Gandhi Government Women & Children Hospital, Puducherry. Ame J Nur Res. 2014;2(1):7-11

Strauss RG, Mock DM, Johnson KJ, Cress GA, Burmeister LF, Zimmerman MB, et al. A randomized clinical trial comparing immediate versus delayed clamping of the umbilical cord in preterm infants: short-term clinical and laboratory endpoints. Transfusion. 2008;48(4):658-65.

Cernadas J, Carroli G, Pellegrini L, Otano L, Ferreira M, Ricci C, et al. The effect of timing of cord clamping on neonatal venous hematocrit values and clinical outcome at term: A randomized, controlled trial. Pediatrics. 2006;117(4):779-86.

Hutton EK, Hassan ES. Late vs early clamping of the umbilical cord in full-term neonates. Systematic review and meta-analysis of controlled trials. JAMA. 2007;297:1241-52.

Emhamed MO, Rheenen PV, Brabin BJ. The early effects of delayed cord clamping in term infants born to Libyan mothers. Trop Doct. 2004;34(4):218-22.

Jaleel R, Deeba F, Khan A. Timing of umbilical cord clamping and neonatal haematological status. J Pak Med Assoc. 2009;59(7):468.

Emhamed MO, Rheenen PV, Brabin BJ. The early effects of delayed cord clamping in term infants born to Libyan mothers. Trop Doct. 2004;34:218-22.

Andersson O, Hellstrom-Westas L, Andersson D, Domellof M. Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomised controlled trial. BMJ. 2011;343:d7157.

Rheenen PV, Moor LD, Eschbach S, Grooth HD, Brabin B. Delayed cord clamping and haemoglobin levels in infancy: a randomised controlled trial in term babies. Trop Med Int Health. 2007;12(5):603-16.

Grajeda R, Perez-Escamilla R, Dewey KG. Delayed clamping of the umbilical cord improves hematologic status of guatemalan infants at 2 months of age. Am J Clin Nutr. 1997;65(2):425-31.