Effect of Delayed Cord Clamping Reduced Anemic Outcome in Preterm Neonate
Phiset Jomjak MD¹, Narong Inploy MD¹, Sinart Prommas MD¹, Buppa Smanchat MD¹, Densak Pongrojpaw MD², Kornkarn Bhamarapravatana PhD³, Komsun Suwannaruk MD² , ⁴
Affiliation : ¹ Department of Obstetrics and Gynecology, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Thailand ² Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand ³ Department of Preclinical Science, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand ⁴ Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
Objective : To compare the effects of immediate versus delayed cord clamping on neonatal outcomes in preterm neonates of gestational age of
32 to 36⁺⁶ weeks, and maternal outcomes.
Materials and Methods : A randomized controlled trial was conducted in the Obstetrics and Gynecology Department at Bhumibol Adulyadej Hospital, in Bangkok, Thailand. The study compared the effects of immediate to delayed cord clamping at 60 seconds among preterm neonates born between 32 weeks, 0 day and 36 weeks, 6 days of gestation between August and October 2018.
Results : The mean age of the participants was 26 years old, and half of the cases were nulliparous. One hundred ten women were randomly separated into two equal groups (n=55). Delayed cord clamping at 60 seconds increased hematocrit levels (Hct) in both two (p=0.004) and 48 (p<0.001) hours after delivery compared to the immediate cord clamping group. There were no differences in exposing the neonate to hypothermia, hypoxemia, Apgar score at 1-minute, polycythemia, intraventricular hemorrhage, hyperbilirubinemia, length of stay in hospital, and affecting the process of resuscitation. There were no statistical differences between the two groups in maternal outcomes such as retained placenta and postpartum hemorrhage.
Conclusion : Delayed cord clamping at 60 seconds increased Hct in the newborn at two to 48 hours after birth. There was no significant difference in adverse maternal and neonatal complications within both groups.
Received 18 December 2018 | Revised 18 February 2019 | Accepted 18 February 2019
doi.org/10.35755/jmedassocthai.2021.05.9614
Keywords : Delayed cord clamping, Hematocrit, Preterm
