Timing of umbilical cord clamping and neonatal jaundice in singleton term pregnancy

Qian, Yiyu; Lu, Qiujing; Shao, Hongyi; Ying, Xinxin; Huang, Wenle; Hua, Ying

doi:10.1016/j.earlhumdev.2019.104948

Cited by 20 publications

(13 citation statements)

References 22 publications

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“…11,12 However, a few studies, including our previous study, reported that DCC did not influence the bilirubin or phototherapy needs of healthy neonates, which was contrary to the results of the present study. 10,13 The object of studies may be the principal element for the discrepant results. Most of the previous studies involved normal pregnant women without complications, including gestational diabetes mellitus, gestational hypertension, intrahepatic cholestasis of pregnancy; but our study focused on pregnant women with GDM.…”

Section: Discussionmentioning

confidence: 99%

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

Shao

Qian

Gao

et al. 2021

Intl J Gynecology & Obste

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Objective: To study the effect of delayed cord clamping (DCC) on the bilirubin levels and hypoglycemia in neonates with diabetic mothers (NDMs).Methods: This is a comparison between a prospective cohort and a historical control cohort. Women with gestational diabetes mellitus who performed DCC were enrolled into the prospective cohort (n = 156), and those who performed early cord clamping (ECC) were enrolled into the historical control cohort (n = 161).Results: NDMs who received DCC had higher transcutaneous bilirubin than those in the ECC group whether maternal glycemic control was good or poor. DCC increased the rate of neonatal hyperbilirubinemia and phototherapy when maternal blood glucose was well controlled but not when it was poorly controlled. No differences were found in initial blood glucose levels on days 1 to 3 of life between the two groups. Conclusion:Delayed cord clamping increased bilirubin levels, the risk of neonatal hyperbilirubinemia, and phototherapy in IDMs without improved initial blood glucose levels. Therefore, DCC was not recommended in NDMs.

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Section: Discussionmentioning

confidence: 99%

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

Shao

Qian

Gao

et al. 2021

Intl J Gynecology & Obste

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“…What's more, the conclusion of the little relationship between DCC in vaginal delivery and the requirement of phototherapy was approved by most researches [3,6,19]. Conversely, our previous study [5] and the report from Japan [20] observed that DCC led to a higher risk of neonatal jaundice requiring phototherapy in healthy term newborns. The different findings may be due to the diversities in the study design, the sample size, and the study population.…”

Section: Discussionmentioning

confidence: 91%

“…Hyperbilirubinemia is considered a potential disadvantage of DCC, while in practice, it does not appear to be associated with increased phototherapeutic demand [3][4][5]. As a simple and safe procedure, DCC proves to be beneficial for a better hematological status in the first several hours or months of full-term newborn's life, including hemoglobin, hematocrit levels [3,[6][7][8], and iron status [9].…”

Section: Introductionmentioning

confidence: 99%

Effects of delayed cord clamping on neonatal jaundice, phototherapy and early hematological status in term cesarean section

Shao

Gao

Lu³

et al. 2021

Ital J Pediatr

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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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“…19,20 If cord clamping occurs within 90 seconds, provided >60 seconds, it may not only improve the early hematologic status of neonates, but also prevent excessive jaundice requiring phototherapy. 21 With regard to obstetric interventions, the results show that after exposure to the banners, there was only a statistical difference in the reduction of professionals favoring the recommendation of the 'Kristeller maneuver' . A Cochrane Library systematic review, 22 with 3,948 women, concluded that there is insufficient evidence for the routine use of the Kristeller maneuver.…”

Section: Discussionmentioning

confidence: 97%

Translation of knowledge based on scientific evidence to improve the clinical practice of obstetricians / Translação do conhecimento baseado em evidências científicas para melhorar a prática clínica de obstetras

Santos

Lima²

2021

RPCF

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Objetivo: avaliar a eficácia de intervenções educativas baseadas em evidências científicas para melhorar a prática clínica de obstetras. Método: estudo longitudinal com enfermeiros e médicos do Hospital Estadual de Santana, Amapá, Brasil, onde realizou-se 21 entrevistas estruturadas na pré e pós-auditoria, além de intervenções educativas com “auditoria e feedback” e “diretrizes de prática clínica” recomendadas pela Cochrane collaboration para provocar mudanças no comportamento dos profissionais de saúde. Os dados foram analisados através de uma escala Likert. Resultados: houve aumento de profissionais favoráveis à recomendação de práticas obstétricas, após as intervenções educativas, com aumento significativo da sutura perineal com fio sintético absorvível e a técnica de compressa morna no períneo; menos profissionais recomendaram as intervenções obstétricas, com redução significativa da manobra de Kristeller no parto. Conclusão: as intervenções educativas proporcionaram melhoras na prática dos profissionais.

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Timing of umbilical cord clamping and neonatal jaundice in singleton term pregnancy

Cited by 20 publications

References 22 publications

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

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

Effects of delayed cord clamping on neonatal jaundice, phototherapy and early hematological status in term cesarean section

Translation of knowledge based on scientific evidence to improve the clinical practice of obstetricians / Translação do conhecimento baseado em evidências científicas para melhorar a prática clínica de obstetras

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