Evaluation of the Effects of Delayed Cord Clamping in Infants of Diabetic Mothers

Abstract

Objective To investigate the effect of delayed cord clamping (DCC) in infants of diabetic mothers. Study Design Women who had diabetes throughout their pregnancy and gave birth at 37 weeks of gestation or later were included in the study along with their babies. Early cord clamping was performed as soon as possible after birth, while DCC was performed by clamping 60 second after birth. The two groups were compared in terms of venous hematocrit (htc) levels and rates of hypoglycemia, jaundice requiring phototherapy, and respiratory distress. Results Venous htc levels at postnatal 6 and 24 hours were significantly higher in the DCC group (p = 0.0001). Polycythemia rates were higher in the DCC group at both 6 and 24 hours, but partial exchange transfusion (PET) was not needed in either group. There were no differences between the groups with regard to the rates of hypoglycemia or jaundice requiring phototherapy. Rate of admission to the neonatal intensive care unit (NICU) was lower in the DCC group. Conclusion Although DCC increased the rate of polycythemia, it did not result in PET requirement. Moreover, DCC reduced the severity of respiratory distress and the rate of admission to NICU due to respiratory distress.

Delayed Cord Clamping in Infants of Diabetic Mothers: Laboratory and Clinical Outcomes

“…22 In our study, rates of hypoglycemia, hypoglycemia requiring glucose infusion, and hypocalcemia were all higher in the ECC group than in the DCC group, but there was also no statistically significant difference. Our results are approximately similar to a previous study, 13 , but they did not discuss hypocalcemia in their results.…”

“…The sample size was calculated by using power and sample size software version 3.0. Based on a previous study done by Korkut et al, 13 the percentage of neonates who needed NICU admission was 27.5% in the early clamping group compared with 10.0% in the delayed clamping group. The total sample size of 154 (77 per group) will be sufficient to detect power of 80% and a significance level of 5%.…”

“…In 2019, Korkut et al 13 studied the effects of DCC on 40 IDMs. They calculated the sample size depending on rates of polycythemia as a primary outcome, but in our study, we calculated sample size based on the indication for NICU admission.…”

“…Our results are in agreement with two previous studies that showed that DCC does not increase the need for phototherapy. 6,13 However, Chaparro et al demonstrated that the need for phototherapy was higher in infants with DCC than in infants with ECC. 22 In our study, rates of hypoglycemia, hypoglycemia requiring glucose infusion, and hypocalcemia were all higher in the ECC group than in the DCC group, but there was also no statistically significant difference.…”

Effect of delayed cord clamping on jaundice and hypoglycemia in the neonates of mothers with gestational diabetes mellitus

“…However, a recent study observed that DCC in NDMs was not associated with a higher rate of neonatal jaundice requiring phototherapy, although performing DCC led to an increased polycythemia ratio, which may be the result of the insufficient sample size. 16 Treatments, whether dietary modification or pharmacological therapies, have been proven to reduce immediate adverse outcomes for neonates-improving some pregnancy outcomes by reducing fetal overgrowth, maternal adiposity, and pregnancy-related hypertension-so a consensus has been reached. 6,17 There are, however, conflicting findings with regard to other outcomes, such as neonatal hyperbilirubinemia and jaundice requiring phototherapy, and neonatal hypoglycemia.…”