Timing of umbilical cord clamping and neonatal haematological status

Abstract

Objectives: To determine the effect of delayed umbilical cord clamping on Hb (haemoglobin) and bilirubin levels of neonates and to identify newborn babies with anaemia and refer them for treatment.

Methods: This Randomized Controlled Trial was conducted in the Department of Obstetrics and Gynaecology, Unit V, Dow Medical College and Lyari General Hospital and Department of Pathology, Lyari General Hospital, between 1st November, 2006 and 15th July, 2007. Patients admitted to labour ward were selected according to inclusion criteria of the study. They were randomly allocated to 2 groups. Group A included women in whom umbilical cord was clamped immediately after birth. In Group B, clamping was delayed until cessation of pulsations in the cord. After cutting the cord, sample of blood was collected from the cut end of cord of the newborn for Hb and bilirubin. After 6 hours of birth, another sample of blood was drawn from antecubital vein for serum bilirubin. Samples were sent to laboratory for analysis. All data were entered and analyzed using SPSS version 11.

Results: Two hundred women were studied, 100 in each of the 2 groups. Mean maternal Hb was 9.75 g/dl in Group A and 9.95 g/dl in Group B. The average neonatal Hb was 14.1 g/dl in Group A and 15.2 g/dl in Group B (p = 0.008). In all 49% neonates in Group A and 37% in Group B had Hb < 14 g/dl. Serum bilirubin values at birth and at 6 hours of birth were 1.8 mg/dl and 2.5 mg/dl for Group A and 1.9 mg/dl and 2.7 mg/dl for Group B, respectively. The difference in bilirubin after 6 hours in the 2 groups was insignificant (p = 0.186).

Conclusion: Delayed umbilical cord clamping at birth seems to be safe and can be expected to reduce the prevalence of anaemic newborn babies in our community.