Effect of Early versus Delayed Umbilical Cord Clamping on Neonatal Haemoglobin Status: A Randomised Controlled Trial

Introduction: Anaemia, especially Iron Deficiency Anaemia (IDA), among neonates and young children, is a major public health problem in India. Umbilical cord clamping after the delivery of the foetus plays an important role in preventing neonatal anaemia. The World Health Organisation (WHO) strongly...

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Bibliographic Details
Main Authors: Mohammed Shahid Attar, Vishwanath Laxman Machakanur, Rajkumar N Marol, Manjula Naik
Format: Article
Language:English
Published: JCDR Research and Publications Pvt. Ltd. 2025-01-01
Series:Indian Journal of Neonatal Medicine and Research
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Online Access:https://www.ijnmr.net/articles/PDF/2439/77298_CE[Ra1]_F(SHU)_PF1(RI_SHU)_redo_PFA_NC(SHU)_PN(SHU).pdf
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Summary:Introduction: Anaemia, especially Iron Deficiency Anaemia (IDA), among neonates and young children, is a major public health problem in India. Umbilical cord clamping after the delivery of the foetus plays an important role in preventing neonatal anaemia. The World Health Organisation (WHO) strongly recommends clamping the cord one minute after delivery, a practice known as late or Delayed Cord Clamping (DCC). In contrast, Early Cord Clamping (ECC) involves clamping the umbilical cord within the first 15-30 seconds of birth, a practice that has been followed since ancient times. Compared to ECC, DCC helps minimise iron deficiency and prevent anaemia in both term and preterm infants. Aim: To study the effect of different cord clamping interventions (DCC and ECC) on neonatal anaemia. Materials and Methods: A prospective randomised controlled trial was conducted in the Department of Paediatrics, Karwar Institute of Medical Sciences, Karwar, Karnataka, India to compare the effects of ECC and DCC in late preterm, term and post-term neonates, using parameters such as Haemoglobin (Hb), Haematocrit (HCT) and serum bilirubin. The present study was carried out in the Department of Paediatrics at a tertiary care teaching hospital in Karwar from July 2023 to December 2024 over a period of six months. A total of 120 newborns were included and randomly allocated to the ECC group (60, where the cord was clamped within 15-20 seconds after birth) and the DCC group (60, where the cord was clamped within 60 seconds of birth). Results: The mean birth weights of the ECC and DCC neonates were 2.66±0.4 kg and 2.73±0.39 kg, respectively. The majority of the study participants were female 62 (51.6%) and term neonates (96, or 80%). The mean Hb and HCT levels were significantly higher in the DCC group compared to the ECC group (p<0.05). Serum bilirubin levels and instances of clinical jaundice did not differ significantly according to statistical analysis between the groups. Conclusion: A significant decreasing trend was noted in neonatal anaemia, along with an increase in Hb and HCT levels in DCC compared to ECC neonates.
ISSN:2277-8527
2455-6890