article · Nigerian Journal of Medicine
This randomised controlled trial compared the effects of early versus delayed umbilical cord clamping on term neonates. Researchers studied 178 mother-baby pairs, measuring neonatal haematocrit at 2 and 24 hours, and serum bilirubin at 24 hours. They also assessed neonatal anaemia, polycythaemia, jaundice, and maternal post-partum blood loss. The study found that delayed cord clamping significantly increased neonatal haematocrit levels at both 2 and 24 hours after birth. However, it also led to significantly higher mean serum total bilirubin at 24 hours. There were no significant differences between the groups in the incidence of neonatal anaemia, polycythaemia, or maternal post-partum blood loss. The findings suggest benefits of delayed cord clamping due to increased haematocrit without adverse outcomes.
The timing of umbilical cord clamping at birth is a debated practice with potential impacts on a baby's health. This research provides evidence to inform clinical guidelines, particularly in settings like Nigeria, by clarifying the effects of different clamping timings on important neonatal health markers.
The abstract does not indicate an application pathway for commercialisation. It suggests a policy change for clinical practice.
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Abstract Background: The optimal timing for umbilical cord clamping, whether it is early cord clamping (ECC) immediately after birth or delayed cord clamping (DCC) done after a certain duration or cessation of cord pulsation, remains a topic of ongoing debate. The choice between these approaches has the potential to impact neonatal outcomes. Aim: The study aimed at comparing the effects of early versus delayed umbilical cord clamping on neonatal haematocrits and serum bilirubin after a normal delivery. Methods: This randomised controlled trial involved 178 term babies and mother pairs randomised into the DCC group (A) and ECC group (B). Neonatal haematocrit was measured at 2 and 24 h of life and serum bilirubin at 24 h of life. Other outcomes included neonatal anaemia, polycythaemia, jaundice and maternal post-partum blood loss. Results: The neonatal haematocrit was significantly higher in babies with delayed compared ECC at two hour ( P = 0.001) and 24 h after birth ( P = 0.001). The mean serum total bilirubin 24 h after birth was significantly higher in babies with DCC ( P = 0.001). The proportion of neonates with anaemia was not significantly different between the two groups ( P = 0.088), likewise the incidence of polycythaemia ( P = 0.146) and post-partum blood loss ( P = 0.097). Conclusion: The study’s findings underscore the benefits of DCC, as it increased neonatal haematocrit levels without leading to adverse maternal or neonatal outcomes and hence should be considered for adoption as a policy in our environment.
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DOI: 10.4103/njm.njm_20_25
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