Is Delaying Cord Clamping until Placenta Delivery Beneficial? Oxygen Saturation and Heart Rate Transition during the Initial 5 Minutes after Delivery in Indian Healthy Newborns

Abstract

Objective This study aimed to compare the preductal oxygen saturation (SpO2) and heart rate (HR) in newborns during the initial 5 minutes after birth with delayed cord clamping (DCC) and early cord clamping (ECC) practices at sea level. Study Design This prospective observational study included newborns born at >34 weeks vaginally (Dharampur, Gujarat) or through caesarean section (CS) (Kolkata, West Bengal). In Dharampur, the newborns received ECC practice (8 weeks) followed by DCC practice (10 weeks). In Kolkata, the newborns received ECC practice only (8 weeks). Results The newborns with DCC (n = 170) had significantly higher SpO2 (3–8%) throughout than those with ECC born either vaginally (n = 178) or through CS (n = 101). The newborns with DCC had slower rise in HR during the first 2 minutes than those with ECC. The 5th and 10th percentile values of SpO2 for newborns with DCC practice were higher than those with ECC practice. Conclusion The trends of SpO2 and HR during the first 5 minutes after birth indicate a relatively smoother cardiopulmonary transition by delaying cord clamping till placental delivery compared with early clamping. The reference ranges can be used for Indian newborns born by uncomplicated vaginal delivery with DCC during the first 5 minutes.

Outcomes of delivery room resuscitation of bradycardic preterm infants: A retrospective cohort study of randomised trials of high vs low initial oxygen concentration and an individual patient data analysis

“…[45] Healthy newborns who underwent delayed cord clamping had lower HRs and higher SpO 2 in the delivery room. [53,54] Our findings should be confirmed in preterm infants who have undergone delayed cord clamping as recommended by current guidelines. [5,7,55] Inadequate ventilation during neonatal resuscitation may lead to prolonged bradycardia.…”

Significance of Neonatal Heart Rate in the Delivery Room—A Review

“…Seven studies that described HR values in mainly non-ventilated newborn infants immediately after birth were included [ 5 , 8 , 9 , 10 , 11 , 12 , 13 ]. Characteristics of these studies are presented in Table 1 .…”

Implementation of Delayed Cord Clamping in public health facilities: a case study from India

“…While it is widely recognized that DCC is more beneficial than Early Cord Clamping (within the first 60 s of birth), the optimal timing of cord clamping continues to be a grey area [ 1 , 17 , 18 ]. A recent study from India recommends delaying clamping until delivery of the placenta [ 19 ]. Feasibility of DCC in caesarean deliveries, or in asphyxiated babies needs further exploration.…”