A study on delayed cord clamping and early skin-to-skin contact and its effects on neonatal outcome

Authors

  • Laxmi Dixit Nee Laxmi Sharma Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
  • Yadav Sushilkumar Gayadin Department of statistics, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
  • Sangeeta Kansal Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
  • Shuchi Jain Sinha Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India https://orcid.org/0000-0002-8067-5758
  • Madhu Jain Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India https://orcid.org/0000-0002-7073-4902

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20240136

Keywords:

Apgar score, Apnoea, Delayed cord clamping, Early skin to skin contact, Hypothermia, Physiological parameter

Abstract

Background: Previous study conducted against immediate tying and cutting of the umbilical cord and suggested waiting until the child had taken repeated breaths and the pulsation in the cord had ceased to prevent potential weakness in the child.  A comparative study between delayed cord clamping (DCC) and early cord clamping (ECC) was carried out on a select group of primigravida without any high-risk factor and delivering at term. The objective of the study was to identify the effects of delayed cord clamping and early skin to skin contact on new born infant’s physiological parameters (temperature, weight, SpO2= saturation of peripheral oxygen, Apgar score= appearance, pulse, grimace, activity, and respiration, Hb=haemoglobin level).

Methods: Study sample consisted of 300 mothers and their new born after gaining mother’s acceptance. They were divided into 2 groups of 150 each. Group A underwent delayed cord clamping and early skin to skin contact and group B early cord clamping. Newborns monitored 24 hours for hypothermia, apnoea, oxygen needs.

Results: The findings of the present study were equivalent among both groups regards the mean neonatal haematological parameters were comparable and slightly elevated hemoglobin level and weight status among late cord clamping compared to early cord clamping group with significant difference was observed at 24 hour later.

Conclusions: This study was found that DCC does have a beneficial effect on temperature, Apgar score, SpO2, Hb level and weight status of new born. Therefore, it is believed that DCC and early skin to skin contact (ESSC) provides effective thermal control with a reduced risk of hypothermia.

References

Darwin E. Zoonomia, Or, The Laws of Organic Life: In Three Parts. Thomas and Andrews, JT Buckingham, printer; 1809.

McDonald SJ, Middleton P, Dowswell T, Morris PS. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Evid Based Child Health. 2014;9(2):303-97.

Raju TN, Singhal N. Optimal timing for clamping the umbilical cord after birth. Clin Perinatol. 2012;39(4):889-900.

Kluckow M, Hooper SB. Using physiology to guide time to cord clamping. Semin Fet Neonat Med. 2015;20(4):225-31.

Mascola MA, Porter TF, Chao TT. Delayed umbilical cord clamping after birth. Obstet Gynecol. 2017;129(1): E5-10.

Chapman J, Marfurt S, Reid J. Effectiveness of delayed cord clamping in reducing postdelivery complications in preterm infants: a systematic review. J Perinat Neonat Nurs. 2016;30(4):372-8.

Vesoulis ZA, Rhoades J, Muniyandi P, Conner S, Cahill AG, Mathur AM. Delayed cord clamping and inotrope use in preterm infants. J Matern Fet Neonat Med. 2018;31(10):1327-34.

Berglund SK, Westrup B, Hägglöf B, Hernell O, Domellöf M. Effects of iron supplementation of LBW infants on cognition and behavior at 3 years. Pediatrics. 2013;131(1):47-55.

Jozoff B, Georgieff MK. Iron deficiency and brain development. Semin Pediatr Neurol. 2005;13(3):158-65.

Bersamin A. Iron and iron deficiency anemia. Nutrition and Health Info Sheet. Available from: https://nutrition.ucdavis.edu/sites/g/files/dgvnsk426/files/content/infosheets/fact-consumer-ironandanemia. Accessed on 2 May 2023.

Armstrong L, Stenson BJ. Use of umbilical cord blood gas analysis in the assessment of the newborn. Arch Dis Childhood-Fet Neonat Edit. 2007;92(6):F430-4.

Radlowski EC, Johnson RW. Perinatal iron deficiency and neurocognitive development. Front Hum Neurosci. 2013;7:585.

Rao R, Bora R. Timing of umbilical cord clamping and infant brain development. J Pediatr. 2018;203:8-10.

Garabedian C, Rakza T, Drumez E, Poleszczuk M, Ghesquiere L, Wibaut B, et al. Benefits of delayed cord clamping in red blood cell alloimmunization. Pediatrics. 2016;137(3).

Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS, Kattwinkel J, Perlman JM, et al. Part 13: neonatal resuscitation: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(suppl 2):S543-60.

Duley LMM, Drife JO, Soe A, Weeks AD. Clamping of the Umbilical Cord and Placental Transfusion. Scientific Impact Paper No. 14. Royal College of Obstetricians and Gynaecologists. 2015.

van Rheenen P, de Moor L, Eschbach S, de Grooth H, Brabin B. Delayed cord clamping and haemoglobin levels in infancy: a randomised controlled trial in term babies. Trop Med Int Health. 2007;12:603-16.

Ceriani Cernadas JM, Carroli G, Pellegrini L, Ferreira M, Ricci C, Casas O, et al. The effect of early and delayed umbilical cord clamping on ferritin levels in term infants at six months of life: a randomized, controlled trial. Arch Argent Pediatr. 2010;108:201-8.

Gupta R, Ramji S. Effect of delayed cord clamping on iron stores in infants born to anemic mothers: a randomized controlled trial. Indian Pediatr. 2002;39:130-5.

Chaparro CM, Neufeld LM, Tena Alavez G, Eguia-Liz Cedillo R, Dewey KG. Effect of timing of umbilical cord clamping on iron status in Mexican infants: a randomised controlled trial. Lancet. 2006;367:1997-2004.

Al-Tawil M, Abdel-Aal R, Kaddah A. A randomized controlled trial on delayed cord clamping and iron status at 3-5 months in term neonates held at the level of maternal pelvis. J Neonat Perinat Med. 2012;5:319-26.

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Published

2024-01-29

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Original Research Articles