Delayed cord clamping in South African neonates with expected low birthweight: a randomised controlled trial

Trop Med Int Health. 2015 Feb;20(2):177-83. doi: 10.1111/tmi.12419. Epub 2014 Nov 2.

Abstract

Objective: To evaluate safety and haematological effects of delayed cord clamping (DCC) in infants with expected low birthweight born in a resource-poor setting.

Methods: Randomised controlled trial involving pregnant women in early labour ≥18 years with intrapartum symphysal-fundal height ≤32 cm. Mothers were randomised for either early cord clamping (ECC, <30 s) or DCC (2-3 min after birth).

Results: We included 104 vigorous infants born by vaginal delivery, of whom 39% had a birthweight <2500 g. Infant haemoglobin (Hb) levels 24 h after birth were significantly higher in the DCC group (18.0 g/dl vs. 16.8 g/dl, P = 0.006). Despite successful placental transfusion, hyperbilirubinemia and hyperviscosity were not observed. Two months after birth, there were no differences in Hb between groups (9.9 g/dl vs. 9.8 g/dl, P = 0.60), but the infants in the DCC group had better weight gain from baseline than those with ECC (2.2 kg vs. 1.9 kg, P = 0.058).

Conclusions: In this South African cohort of newborns with a subnormal distribution of birthweight delayed cord clamping was a safe procedure. Two months after birth the effect of DCC on Hb was not detectable anymore. DCC should be promoted in every singleton delivery in a resource-poor setting irrespective of the birthweight.

Keywords: anaemia; anemia; anémie; bajo peso al nacer; clampage du cordon; cord clamping; haematology; hematología; hématologie; low birthweight infants; neonatos; nourrissons de faible poids de naissance; pinzamiento del cordón.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Constriction
  • Delivery, Obstetric / methods*
  • Female
  • Hemoglobins / analysis*
  • Humans
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Male
  • South Africa
  • Time Factors
  • Treatment Outcome
  • Umbilical Cord*
  • Young Adult

Substances

  • Hemoglobins