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Effect of Early versus Delayed Cord Clamping on Hematological Status of Preterm Infants at 6 wk of Age

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Abstract

Objective

To compare the effect of early cord clamping (ECC) vs. delayed cord clamping (DCC) on hematocrit and serum ferritin at 6 wk of life in preterm infants.

Methods

This randomized controlled trial was conducted in the delivery room and neonatal intensive care unit of a tertiary hospital. One hundred preterm infants born between 30 0/7 and 36 6/7    wk were randomized to either early or delayed cord clamping groups. Parental informed consent was obtained prior to the delivery. In the ECC group, the cord was clamped immediately after the delivery of the baby and in the DCC group; the cord was clamped beyond 2 min after the baby was delivered. Hematocrit and serum ferritin at 6 wk of life were the primary outcomes. Incidence of anemia, polycythemia and significant jaundice were the main secondary outcomes.

Results

The mean hematocrit (27.3 ± 3.8 % vs. 31.8 ± 3.5 %, p value 0.00) and the mean serum ferritin (136.9 ± 83.8 ng/mL vs.   178.9 ± 92.8 ng/mL, p value 0.037) at 6 wk of age were significantly higher in the infants randomized to DCC group. The hematocrit on day 1 was also significantly higher in the DCC group (50.8 ±5.2 % vs. 58.5 ±5.1 %, p value 0.00). The DCC group required significantly longer duration of phototherapy (55.3 ± 40.0 h vs. 36.7 ± 32.6 h, p value 0.016) and had a trend towards higher risk of polycythemia.

Conclusions

Delaying the cord clamping by 2 min, significantly improves the hematocrit value at birth and this beneficial effect continues till at least 2nd mo of life.

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Contributions

TR: Involved in conceiving and designing the study, protocol development, patient recruiting, outcome assessment and writing of manuscript; SN: Involved in study design, writing of manuscript, randomization of study population and statistical analysis; SR: Involved in study design, writing of manuscript; JPS, CA and BSC: Involved in patient screening and collection of data; SB: Supervised the design and execution of study, outcome assessment, writing of manuscript. She will act as guarantor of the study. The final manuscript was approved by all the authors.

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Authors and Affiliations

  1. Department of Neonatology, St. John’s Medical College & Hospital, Bangalore, Karnataka, India

    Thomas Ranjit, Saudamini Nesargi, P. N. Suman Rao, Jagdish Prasad Sahoo, C. Ashok, B. S. Chandrakala & Swarnarekha Bhat

  2. Department of Neonatology, CIMAR COCHIN Hospital, Cheranallore, Edapally, Kochi, 682034, India

    Thomas Ranjit

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  1. Thomas Ranjit
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Correspondence to Thomas Ranjit.

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Ranjit, T., Nesargi, S., Rao, P.N.S. et al. Effect of Early versus Delayed Cord Clamping on Hematological Status of Preterm Infants at 6 wk of Age. Indian J Pediatr 82, 29–34 (2015). https://doi.org/10.1007/s12098-013-1329-8

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  • DOI: https://doi.org/10.1007/s12098-013-1329-8

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