Effect of Delayed Cord Clamping at 30 Seconds and 1 Minute on Neonatal Hematocrit in Term Cesarean Delivery: A Randomized Trial

• Main Authors: Songthamwat M, Witsawapaisan P, Tanthawat S, Songthamwat S
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-06-01
• Series: International Journal of Women's Health
• Subjects: delayed cord clamping; timing; hematocrit; neonatal anemia
• Online Access: https://www.dovepress.com/effect-of-delayed-cord-clamping-at-30-seconds-and-1-minute-on-neonatal-peer-reviewed-article-IJWH

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, ThailandCorrespondence: Metha SongthamwatDepartment of Obstetrics and Gynecology, Udonthani Hospital, Udonthani 41000, ThailandEmail [e-mail]: 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