Effect of Delayed Cord Clamping at 30 Seconds and 1 Minute on Neonatal Hematocrit in Term Cesarean Delivery: A Randomized Trial
Authors Songthamwat M, Witsawapaisan P, Tanthawat S, Songthamwat S
Received 7 February 2020
Accepted for publication 9 June 2020
Published 23 June 2020 Volume 2020:12 Pages 481—486
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Elie Al-Chaer
Metha Songthamwat,1 Patthamon Witsawapaisan,1 Sopida Tanthawat,2 Srisuda Songthamwat1
1Department of Obstetrics and Gynecology, Udonthani Hospital, Udonthani, Thailand; 2Department of Pediatrics, Udonthani Hospital, Udonthani, Thailand
Correspondence: Metha Songthamwat
Department of Obstetrics and Gynecology, Udonthani Hospital, Udonthani 41000, Thailand
Objective: To compare the effect of delayed cord clamping at 30 seconds and 1 minute on the incidence of neonatal hematocrit, anemia, maternal and neonatal complications in term cesarean delivered neonates.
Methods: An opened labelled, randomized controlled trial was undertaken. The 160 healthy term cesarean-born neonates were randomly allocated to either 30 seconds or 1-minute groups of delayed cord clamping (DCC) (groups 1 and 2). Neonatal venous hematocrit (Hct) and microbilirubin (Mb) were measured at 48– 72 hours after birth.
Results: One hundred and fifty-nine neonates completed this study. Mean neonatal hematocrit ± standard deviation at 48– 72 hours was 49.9 ± 6.0% in group 1 and 51.2 ± 5.9% in group 2 without a statistical difference. Neonatal anemia (Hct less than 45%) occurred in 14/79 neonates (17.7%) in group 1 and in 8/80 cases (10.0%) in group 2 without a significant difference between groups. The incidence of neonatal jaundice and polycythemia (hematocrit more than 65%) was similar between groups. There were no significant differences; in the estimated blood loss during the operation, the incidence of postpartum hemorrhage and other maternal and neonatal complications.
Conclusion: Neonatal hematocrit was not significantly different following DCC at 30 seconds and at 1 minute, but the incidence of neonatal anemia decreased with the longer timing of DCC. The estimated blood loss and other complications were not different between the two groups. Therefore, one minute-DCC should be considered for neonatal anemic prevention when compared with 30 seconds-DCC.
Keywords: delayed cord clamping, timing, hematocrit, neonatal anemia
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