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Background Delayed cord clamping in full-term neonates is widely recommended, while in practice, it is rarely implemented in cesarean section due to the fear of neonatal jaundice and excessive maternal blood loss. The optimal timing of cord clamping remains uncertain. This study was to fully evaluate the effects of delayed cord clamping on short-term hematological status and jaundice in term neonates delivered by cesarean section. Methods This retrospective study enrolled 796 women, who were allocated into the early cord clamping group (n = 377) and the delayed cord clamping group (n = 419). The latter group was further divided into two subgroups (30–60 s, 61–120 s). The outcomes were neonatal transcutaneous bilirubin levels on 0 to 5 days of life and the rate of phototherapy. For neonates who had blood tests on the first three days of life, their hemoglobin and hematocrit were compared among groups. Results Compared with the early cord clamping group, delayed cord clamping merely increased the transcutaneous bilirubin level of neonates on the day of birth rather than that on the following five days. The heel peripheral blood sample size of 1–3 days in the early cord clamping group was 61, 25 and 33, and in the delayed cord clamping group was 53, 46 and 32, respectively. Delayed cord clamping at 30–60 s resulted in the higher neonatal hemoglobin level on day 3 and an increased rate of neonatal polycythemia, without a higher rate of phototherapy. Delayed cord clamping beyond 60 s did not further improve hematological status in term neonates born by cesarean section. Conclusion In cesarean section, delayed cord clamping for 30–60 s improved the early hematological status of term neonates without the enhanced requirement of phototherapy for neonatal jaundice.

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Purpose: To investigate the effect of later cord clamping on bilirubin levels and phototherapy rates in normal pregnancy term neonates and diabetic pregnancy neonates.Methods: This is a prospective study that enrolled pregnant women without pregnancy complications and those with diabetes according to the criteria. The subjects were randomized in a 1:1 ratio to either immediate cord clamping or later cord clamping. The final data analysis involved 132 cases of diabetic pregnancy and 129 cases of normal pregnancy. The main outcomes were neonatal the transcutaneous bilirubin values in 2-4 days postpartum and the phototherapy rate.Results: In diabetic pregnancy, neonatal bilirubin levels on the 2-4 day postpartum and phototherapy rates were significantly higher in later cord clamping group than in immediate cord clamping group, while in normal pregnancy, there was no statistical difference in bilirubin values and phototherapy rates between different clamping methods. After receiving later cord clamping, bilirubin levels on the third postnatal day and the rate of neonates needing phototherapy were higher in the diabetic pregnancy group than in the normal pregnancy group.Conclusions: Later cord clamping increases the risk of jaundice in newborns whose mothers have diabetes, but has no effect on newborns with normal pregnancy.Trial registration: ClinicalTrials.gov: NCT04369313; date of registration: April 27, 2020 (retrospectively registered)