OBJECTIVES: This study was carried out to assess whether delaying umbilical cord clamping is effective in improving the haematological status of term infants living in a malaria-endemic area, and whether this is associated with complications in infants and mothers. METHODS: We randomly assigned women delivering term babies in Mpongwe Mission Hospital, Zambia, to delayed cord clamping (DCC, n = 46) or immediate cord clamping (controls, n = 45) and followed their infants on a bi-monthly basis until the age of 6 months. We compared the haemoglobin (Hb) change from cord values and the proportion of anaemic infants. Secondary outcomes related to infant and maternal safety. RESULTS: Throughout the observation period infant Hb levels in both groups declined, but more rapidly in controls than in the DCC group [difference in Hb change from baseline at 4 months 1.1 g/dl, 95% confidence interval (CI) 0.2; 2.1]. By 6 months, this difference had disappeared (0.0 g/dl, 95% CI -0.9; 0.8). The odds ratio for iron deficiency anaemia in the DCC group at 4 months was 0.3 (95% CI 0.1; 1.0), but no differences were found between the groups at 6 months. No adverse events were seen in infants and mothers. CONCLUSION: Our findings indicate that DCC could help improve the haematological status of term infants living in a malaria-endemic region at 4 months of age. However, the beneficial haematological effect disappeared by 6 months. This simple, free and safe delivery procedure might offer a strategy to reduce early infant anaemia risk, when other interventions are not yet feasible.
RCT Entities:
OBJECTIVES: This study was carried out to assess whether delaying umbilical cord clamping is effective in improving the haematological status of term infants living in a malaria-endemic area, and whether this is associated with complications in infants and mothers. METHODS: We randomly assigned women delivering term babies in Mpongwe Mission Hospital, Zambia, to delayed cord clamping (DCC, n = 46) or immediate cord clamping (controls, n = 45) and followed their infants on a bi-monthly basis until the age of 6 months. We compared the haemoglobin (Hb) change from cord values and the proportion of anaemic infants. Secondary outcomes related to infant and maternal safety. RESULTS: Throughout the observation period infant Hb levels in both groups declined, but more rapidly in controls than in the DCC group [difference in Hb change from baseline at 4 months 1.1 g/dl, 95% confidence interval (CI) 0.2; 2.1]. By 6 months, this difference had disappeared (0.0 g/dl, 95% CI -0.9; 0.8). The odds ratio for iron deficiency anaemia in the DCC group at 4 months was 0.3 (95% CI 0.1; 1.0), but no differences were found between the groups at 6 months. No adverse events were seen in infants and mothers. CONCLUSION: Our findings indicate that DCC could help improve the haematological status of term infants living in a malaria-endemic region at 4 months of age. However, the beneficial haematological effect disappeared by 6 months. This simple, free and safe delivery procedure might offer a strategy to reduce early infantanaemia risk, when other interventions are not yet feasible.
Authors: Lisa Umphrey; Morten Breindahl; Alexandra Brown; Ola Didrik Saugstad; Marta Thio; Daniele Trevisanuto; Charles Christoph Roehr; Mats Blennow Journal: Neonatology Date: 2018-05-25 Impact factor: 4.035
Authors: Myra H Wyckoff; Eunice M Singletary; Jasmeet Soar; Theresa M Olasveengen; Robert Greif; Helen G Liley; David Zideman; Farhan Bhanji; Lars W Andersen; Suzanne R Avis; Khalid Aziz; Jason C Bendall; David C Berry; Vere Borra; Bernd W Böttiger; Richard Bradley; Janet E Bray; Jan Breckwoldt; Jestin N Carlson; Pascal Cassan; Maaret Castrén; Wei-Tien Chang; Nathan P Charlton; Adam Cheng; Sung Phil Chung; Julie Considine; Daniela T Costa-Nobre; Keith Couper; Katie N Dainty; Peter G Davis; Maria Fernanda de Almeida; Allan R de Caen; Edison F de Paiva; Charles D Deakin; Therese Djärv; Matthew J Douma; Ian R Drennan; Jonathan P Duff; Kathryn J Eastwood; Walid El-Naggar; Jonathan L Epstein; Raffo Escalante; Jorge G Fabres; Joe Fawke; Judith C Finn; Elizabeth E Foglia; Fredrik Folke; Karoline Freeman; Elaine Gilfoyle; Craig A Goolsby; Amy Grove; Ruth Guinsburg; Tetsuo Hatanaka; Mary Fran Hazinski; George S Heriot; Karen G Hirsch; Mathias J Holmberg; Shigeharu Hosono; Ming-Ju Hsieh; Kevin K C Hung; Cindy H Hsu; Takanari Ikeyama; Tetsuya Isayama; Vishal S Kapadia; Mandira Daripa Kawakami; Han-Suk Kim; David A Kloeck; Peter J Kudenchuk; Anthony T Lagina; Kasper G Lauridsen; Eric J Lavonas; Andrew S Lockey; Carolina Malta Hansen; David Markenson; Tasuku Matsuyama; Christopher J D McKinlay; Amin Mehrabian; Raina M Merchant; Daniel Meyran; Peter T Morley; Laurie J Morrison; Kevin J Nation; Michael Nemeth; Robert W Neumar; Tonia Nicholson; Susan Niermeyer; Nikolaos Nikolaou; Chika Nishiyama; Brian J O'Neil; Aaron M Orkin; Osokogu Osemeke; Michael J Parr; Catherine Patocka; Jeffrey L Pellegrino; Gavin D Perkins; Jeffrey M Perlman; Yacov Rabi; Joshua C Reynolds; Giuseppe Ristagno; Charles C Roehr; Tetsuya Sakamoto; Claudio Sandroni; Taylor Sawyer; Georg M Schmölzer; Sebastian Schnaubelt; Federico Semeraro; Markus B Skrifvars; Christopher M Smith; Michael A Smyth; Roger F Soll; Takahiro Sugiura; Sian Taylor-Phillips; Daniele Trevisanuto; Christian Vaillancourt; Tzong-Luen Wang; Gary M Weiner; Michelle Welsford; Jane Wigginton; Jonathan P Wyllie; Joyce Yeung; Jerry P Nolan; Katherine M Berg Journal: Resuscitation Date: 2021-11-11 Impact factor: 5.262
Authors: Cecily M Begley; Gillian Ml Gyte; Declan Devane; William McGuire; Andrew Weeks; Linda M Biesty Journal: Cochrane Database Syst Rev Date: 2019-02-13