Obstet Gynecol Sci.  2018 Nov;61(6):655-661. 10.5468/ogs.2018.61.6.655.

Safety of delayed umbilical cord clamping in preterm neonates of less than 34 weeks of gestation: a randomized controlled trial

• Rana A
• Agarwal K
• Ramji S
• Gandhi G
• Sahu L

• KMID: 2426008
• DOI: http://doi.org/10.5468/ogs.2018.61.6.655

Abstract

OBJECTIVE
There is concern regarding the safety of delayed cord clamping (DCC) in babies born at less than 34 weeks' gestation. Therefore, the primary objective of this study was to compare the rates of hyperbilirubinemia and polycythemia during initial 7 days in infants born at less than 34 weeks' gestation and randomized to receive DCC by 120 seconds or early cord clamping (ECC) within less than 30 seconds.
METHODS
One hundred pregnant women were randomly subjected to DCC or ECC at the time of birth in a tertiary referral hospital setting. Blood samples were obtained from each newborn at 48 hours and 7 days for hematocrit measurement. Serum bilirubin levels were estimated once the infant had clinically significant jaundice or at 72 hours. For the statistical analysis, the χ2 test, student's t-test, or Wilcoxon rank sum test was used.
RESULTS
The hematocrit was significantly higher in the DCC group than in the ECC group (P < 0.001). None of the babies had polycythemia. Mean total serum bilirubin level was 6.6 mg/dL in the DCC group and 8.7 mg/dL in the ECC group (P < 0.001). There was no increased risk of hyperbilirubinemia in the DCC group.
CONCLUSION
DCC benefits preterm neonates with no significant adverse effects.

Keyword

Preterm; Neonates; Polycythemia; Hyperbilirubinemia; Clamping

MeSH Terms

Bilirubin
Constriction*
Female
Hematocrit
Humans
Hyperbilirubinemia
Infant
Infant, Newborn*
Jaundice
Parturition
Polycythemia
Pregnancy*
Pregnant Women
Tertiary Care Centers
Umbilical Cord*
Bilirubin

Figure

• 

  Fig. 1 Participant flow through the study. NA, not applicable.

• 

  Fig. 2 Hematocrit in newborns at 48 hours and the 7th day of life (Y-axis, hematocrit in % age). DCC, delayed cord clamping; ECC, early cord clamping.

• 

  Fig. 3 Total serum bilirubin levels in newborns at 72 hours (Y-axis, total serum bilirubin levels in mg/dL). DCC, delayed cord clamping; ECC, early cord clamping.

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