A randomized controlled study of immediate versus delayed umbilical cord clamping in infants born by elective caesarean section

Ital J Pediatr. 2020 May 24;46(1):71. doi: 10.1186/s13052-020-00835-2.

Abstract

Background: Delayed umbilical cord clamping is associated with greater haemoglobin concentration and iron storage between 3 and 6 months of life and with less need of blood transfusion and lower incidence of neonatal hypotension compared to early umbilical cord clamping.

Methods: The aim was to test the hypothesis that delayed cord clamping is better than early cord clamping in term infants born by elective caesarean section. Group A was subjected to immediate cord clamping while in the Group B, the umbilical cord was clamped 1 min after birth. Primary aim was revealed the difference in pre-ductal saturation between two groups while secondary aim was investigating the difference in HR, Ht, bilirubin and glycaemia. Pre-ductal SpO2 and HR were recorded at 5 and 10 min after birth, T was analysed 10 min after birth, glycaemia was revealed at 120 min while Ht and bilirubin were collected at 72 h.

Results: 132 newborns were enrolled in the study and allocated in ratio 1:1 to group A or B. Delayed cord clamping did not improve SpO2, HR and T values compared to immediate cord clamping (p > 0,05). However, Group B showed greater haematocrit and bilirubin values at 72 h compared to Group A (56,71 ± 6663 vs 51,56 ± 6929; p < 0,05 and 8,54 ± 2,90 vs 7,06 ± 2,76; p < 0,05). Glycaemia value did not differ between two groups (p > 0,05).

Conclusions: Group B did not reveal any differences in SpO2, HR, T and glycaemia compared to Group A. Group B showed greater values of haematocrit and bilirubin but without need of phototherapy.

Trial registration: Umbilical Cord Clamping: What Are the Benefits; NCT03878602. Registered 18 March 2019 retrospectively registered.

Keywords: Delayed cord clamping; Elective caesarean section; Newborns.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Bilirubin / blood
  • Blood Gas Analysis
  • Blood Glucose / metabolism
  • Body Temperature
  • Cesarean Section*
  • Constriction
  • Female
  • Heart Rate
  • Hematocrit
  • Humans
  • Infant, Newborn
  • Male
  • Pregnancy
  • Time Factors
  • Umbilical Cord / surgery*

Substances

  • Blood Glucose
  • Bilirubin

Associated data

  • ClinicalTrials.gov/NCT03878602