Effect of Delayed Cord Clamping at 30 Seconds and 1 Minute on Neonatal Hematocrit in Term Cesarean Delivery: A Randomized Trial

Metha Songthamwat, Patthamon Witsawapaisan, Sopida Tanthawat, Srisuda Songthamwat, Metha Songthamwat, Patthamon Witsawapaisan, Sopida Tanthawat, Srisuda Songthamwat

Abstract

Objective: To compare the effect of delayed cord clamping at 30 seconds and 1 minute on the incidence of neonatal hematocrit, anemia, maternal and neonatal complications in term cesarean delivered neonates.

Methods: An opened labelled, randomized controlled trial was undertaken. The 160 healthy term cesarean-born neonates were randomly allocated to either 30 seconds or 1-minute groups of delayed cord clamping (DCC) (groups 1 and 2). Neonatal venous hematocrit (Hct) and microbilirubin (Mb) were measured at 48-72 hours after birth.

Results: One hundred and fifty-nine neonates completed this study. Mean neonatal hematocrit ± standard deviation at 48-72 hours was 49.9 ± 6.0% in group 1 and 51.2 ± 5.9% in group 2 without a statistical difference. Neonatal anemia (Hct less than 45%) occurred in 14/79 neonates (17.7%) in group 1 and in 8/80 cases (10.0%) in group 2 without a significant difference between groups. The incidence of neonatal jaundice and polycythemia (hematocrit more than 65%) was similar between groups. There were no significant differences; in the estimated blood loss during the operation, the incidence of postpartum hemorrhage and other maternal and neonatal complications.

Conclusion: Neonatal hematocrit was not significantly different following DCC at 30 seconds and at 1 minute, but the incidence of neonatal anemia decreased with the longer timing of DCC. The estimated blood loss and other complications were not different between the two groups. Therefore, one minute-DCC should be considered for neonatal anemic prevention when compared with 30 seconds-DCC.

Keywords: delayed cord clamping; hematocrit; neonatal anemia; timing.

Conflict of interest statement

The authors report no conflicts of interest in this work.

© 2020 Songthamwat et al.

Figures

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Figure 1
Consort diagram.

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