Efficacy of Delayed versus Immediate Cord Clamping in Late Preterm Newborns following Normal Labor: A Randomized Control Trial
Rasita Salae MD*, Chamnan Tanprasertkul MD, MSc*, Charintip Somprasit MD*, Kornkarn Bhamarapravatana PhD**, Komsun Suwannarurk MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand ** Department of Preclinical Science, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Background : Premature neonates are susceptible to anemic problems with low iron storage. Delayed cord clamping (DCC)
has been studied and its beneficial value has been supported by existing research in newborns with very low birth weights. But
there were only few data pertinent to late preterm infants.
Objective : To investigate the effect of delayed cord clamping (DCC) as compared with immediate cord clamping (ICC) on the
hematocrit level at 48 hours in late preterm neonates after vaginal delivery.
Material and Method: The design consisted of a randomized controlled trial. One hundred pregnant women who were
admitted because of preterm labor (GA 34-36+6 week) in active phase were recruited and allocated into two groups,
designated as the ICC and DCC groups. The DCC were defined as the case in which patients underwent the umbilical cord
clamping at 120 seconds after birth. At 48 hours after delivery, both the hematocrit (Hct) and microbilirubin (MB) levels of
newborns were determined. Also, neonatal and maternal complications were recorded.
Result: Eighty-six neonates were analyzed. There were no statistical differences in the baseline data of maternal symptoms
and newborns between the two groups. Neonates in the DCC group had a significantly higher hematocrit level than the ICC
group (55.4% and 47.6%, respectively: p = 0.02). The MB level in the DCC group was also significantly higher than in the
ICC group (9.4% and 8.6 mg %, respectively: p = 0.04). However, phototherapy and length of hospitalization in both groups
were not different. There were no serious maternal and fetal complications in either group.
Conclusion : The DCC procedure could raise the Hct level in the late preterm newborns without serious adverse effects. But
more evidence is needed to explore the possible benefit of this procedure.
Keywords : Delayed cord clamping, Late preterm, Hematocrit, Microbilirubin
