Effect of delayed versus early umbilical cord clamping on neonatal outcomes: A prospective randomized comparative study.

Dr. Parvathaneni  Divya; Dr SORNALATHA C.L; Dr. Ashmitaa  Srianand; Konka Sekar  Chaitanya

doi:10.51168/sjhrafrica.v7i3.2529

Authors

Dr. Parvathaneni Divya Assistant professor, Indira Medical College, affiliated to The T.N. Dr M.G.R. Medical University
Dr. Sornalatha C.L. Senior Resident, Indira Medical College, affiliated to The T.N. Dr .M.G.R. Medical University
Dr . Ashmitaa Srianand Senior Registrar Affiliation- Kauvery Hospitals -Radial Road, Chennai
Dr . Konka Sekar Chaitanya Assistant Professor, Department of General Surgery, Government Medical College, Thiruvallur

DOI:

https://doi.org/10.51168/sjhrafrica.v7i3.2529

Keywords:

Delayed cord clamping, Early cord clamping, Neonatal hemoglobin, Hematocrit, Placental transfusion, Neonatal outcomes, Birth weight, Hyperbilirubinemia, Polycythemia, Postpartum hemorrhage

Abstract

Background

The timing of umbilical cord clamping plays an important role in neonatal transition and hematological status. Delayed cord clamping has been proposed to improve neonatal outcomes by enhancing placental transfusion and increasing iron stores.

Objective: To compare the effects of delayed versus early umbilical cord clamping on neonatal hematological parameters and clinical outcomes in term neonates.

Materials and methods

A prospective randomized comparative study was conducted in the Department of Obstetrics and Gynaecology at CSI Hospital, Bangalore, from August 2014 to May 2016. A total of 400 term pregnant women were randomly allocated into two groups: early cord clamping (ECC, n = 200) performed within 15 seconds of birth, and delayed cord clamping (DCC, n = 200) performed after cessation of cord pulsations. The mean age of participants was 26.4 ± 3.2 years, with the majority being multigravida (62%). Neonatal hemoglobin and hematocrit levels were measured at 48 hours. Secondary outcomes included bilirubin levels, requirement of phototherapy, birth weight, APGAR scores, respiratory distress, polycythemia, and maternal postpartum hemorrhage.

Results

Mean neonatal hemoglobin and hematocrit were significantly higher in the DCC group (17.6 ± 1.5 g/dL and 52.9 ± 5.3%) compared to the ECC group (16.8 ± 1.4 g/dL and 50.17 ± 4.7%) (p < 0.001). Birth weight was also significantly higher in the DCC group (p = 0.017). No significant differences were observed between the groups with respect to phototherapy requirement, polycythemia, respiratory distress, APGAR scores, or maternal postpartum hemorrhage.

Conclusion

Delayed cord clamping improves neonatal hematological status without increasing maternal or neonatal complications.

Recommendations

Delayed cord clamping can be safely recommended as a routine practice in term deliveries.

Author Biographies

Dr. Parvathaneni Divya, Assistant professor, Indira Medical College, affiliated to The T.N. Dr M.G.R. Medical University

is an Assistant Professor in Obstetrics and Gynaecology at Indira Medical College, Tamil Nadu, India. She holds an MBBS, DNB (OBG), PGDMLE, and DRM. Her research interests include maternal-fetal medicine and evidence-based obstetric practices.

Dr. Sornalatha C.L., Senior Resident, Indira Medical College, affiliated to The T.N. Dr .M.G.R. Medical University

is a Senior Resident in Obstetrics and Gynaecology at Indira Medical College, Tamil Nadu, India. She holds an MS in Obstetrics and Gynaecology and is a Member of the Royal College of Obstetricians and Gynaecologists (MRCOG). Her clinical interests include high-risk pregnancy and neonatal care.

Dr . Ashmitaa Srianand, Senior Registrar Affiliation- Kauvery Hospitals -Radial Road, Chennai

is a Senior Registrar at Kauvery Hospitals, Radial Road, Chennai. She holds an MBBS, MS (OBG), DNB (OBG), and MRCOG. She has expertise in minimal access surgery and obstetric emergencies.

Dr . Konka Sekar Chaitanya, Assistant Professor, Department of General Surgery, Government Medical College, Thiruvallur

is an Assistant Professor in the Department of General Surgery at Government Medical College, Thiruvallur, Tamil Nadu. He holds an MBBS and an MS in General Surgery. His research interests include surgical outcomes and perioperative care.

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