Late umbilical cord clamping, neonatal hematocrit and Apgar scores: A randomized controlled trial

Abstract

OBJECTIVE: Based on current evidence, there is a little agreement on the best timing for after birth umbilical cord clamping. This study was designed to compare the impact of using two different times for cord clamping on hematocrit concentration and Apgar scores of the neonate. STUDY DESIGN: Fifty-six healthy full-term vaginally born neonates were allocated to early (10 seconds after delivery) and late (3 minutes after delivery) umbilical cord clamping groups in this randomized clinical trial. We recorded the length of the 3rd stage of labor and Apgar score at 5 minutes. Infant's hematocrit was measured at 2 and 18 hours of age. RESULTS: Neonatal hematocrit differed between the two groups. Late cord clamping group had greater hematocrit at 2 hours (45.5 ± 4 vs. 49.5 ± 4.4, P = 0.0003) and 18 hours (47.7 ± 5.5 vs. 52.9 ± 4.3, P = 0.0002). Apgar scores at 5 minutes (9.3 ± 0.6 vs. 9.4 ± 0.6, p = 0.5) and duration of delivery 3rd stage (10.2 ± 3.7 min vs. 8.9 ± 5 min, P = 0.2) did not differ between early and late cord clamping groups respectively. CONCLUSION: Late cord clamping leads to a significant increase in the hematocrit of the neonate but it does not have effects on Apgar score and duration of the 3rd stage of labor.

Effect of early and delayed cord clamping on hemoglobin and hematocrit among full term neonates.

“…12 Improvement in Hb, HCT with increased risk of polycythemia after delayed cord clamping in neonates was shown by Rincon D, et no effect on the APGAR score and duration of third stage of labor. 5,13 Even the chances of maternal postpartum hemorrhaging and/or neonate jaundice are also no affected, as was seen by Chien, PC, et al in a study in 2015. 14 Similar conclusions were made in a study in 2017.…”

The effect of delayed umbilical cord clamping on Newborn's oxygen saturation and sucking success in primiparous pregnant

“…In their study on ≥33‐week newborns, Ashish et al 9 found the Apgar scores in the first, fifth, and tenth minutes higher in the group with delayed cord clamping than the group with early cord clamping. In the study of Salari et al 28 on healthy newborns, the cord was clamped in the postpartum 3rd minute in the experimental group and postpartum 10 s in the control group. The Apgar scores in the fifth minute were found to be slightly higher in the experimental group, but the difference between them was not statistically significant.…”

Effects of timing of umbilical cord clamping for mother and newborn: a narrative review

“…The timing of umbilical cord clamping extended from immediately to 5 min or no pulsation of the umbilical cord, the literature review showed a high heterogeneity of management of cord clamping. Out of 12 articles, 3 were meta-analyses and 9 RCTs and no RCTs were included which were already included in one of the meta-analyses [14][15][16][17][18][19][20][21][22][23][24][25]. The study population in the different RCTs ranged from 56 to 720 participants [14,15,17,[19][20][21][22][23][24].…”

“…Out of 12 articles, 3 were meta-analyses and 9 RCTs and no RCTs were included which were already included in one of the meta-analyses [14][15][16][17][18][19][20][21][22][23][24][25]. The study population in the different RCTs ranged from 56 to 720 participants [14,15,17,[19][20][21][22][23][24]. The details of included studies can be found in Table 1.…”