Impact of Delaying Cord Clamping on Neonatal Jaundice: Randomized Controlled Trail

• Main Authors: Pei-Chun Chien, 簡珮君
• Other Authors: Meei-Ling Gau
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/872q4c

碩士 === 國立臺北護理健康大學 === 護理助產研究所 === 103 === Purpose This study investigates the impact of delayed cord clamping on neonatal jaundice and postpartum hemorrhage. Methods A randomized controlled trial was conducted at a regional teaching hospital in northern Taiwan. One hundred and five healthy, nulliparous women during their 36th week of pregnancy were included and randomly allocated to either the experiment group (n = 44) or the control group (n = 61). Participants in the experiment group received delayed cord clamping (DCC) at 3 minutes postpartum. Participants in the control group received early cord clamping (ECC) at around 1 minute postpartum. The level of infant transcutaneous bilirubin (TcB) and the presence of postpartum hemorrhaging at 24, 48, and 72 hours postpartum were used as the clinical outcome measures. Because neonatal jaundice is associated with multiple potential causes, the present study assessed the effect of relevant demographic factors, newborn sucking efficacy, and breastfeeding scale data on this condition. Data analysis included descriptive statistics, independent t-test, chi-square test, and the generalized estimating equation (GEE). Results / Conclusions Results found no significant difference between the two groups in terms of either neonatal jaundice or maternal postpartum hemorrhage. However, we found the rate of newborn weight loss to be significantly related to TcB level, with a 1% rise in weight loss associated with a 0.05mg/dl rise in TcB level (p<.05). Delayed cord clamping was not found to be associated with either bleeding during labor or presence of postpartum hemorrhaging at three days postpartum. Clinical Application The present study provides evidence that delayed cord clamping does not increase neonatal jaundice or maternal postpartum hemorrhage. Therefore, this study sheds important new light onto the still controversial issue of delayed cord clamping. Our results support the continued practice of DCC. We suggest that the benefits of practicing DCC be incorporated into maternity education and, in most cases, that new mothers should be permitted to determine the method of cord clamping used. Finally, clinical nurses and midwives should monitor the food intake and the rate of bodyweight loss in newborn infants in order to insure they receive adequate nutrition, which is an important factor in reducing the need for phototherapy and the resulting maternal separation.