Chukwuemeka Jude Ofojebe1, George Uchenna Eleje2, Joseph Ifeanyichukwu Ikechebelu1, Boniface Chukwuneme Okpala1, Binyelum Adaobi Ofojebe3, Emmanuel Onyebuchi Ugwu4, Emeka Philip Igbodike5, Arinze Anthony Onwuegbuna6, David Chibuike Ikwuka7, Chidebe Christian Anikwe8, Toochukwu Benjamin Ejikeme8. 1. Effective care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Nnewi campus, Nigeria; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria. 2. Effective care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Nnewi campus, Nigeria; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria. Electronic address: gu.eleje@unizik.edu.ng. 3. Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria. 4. Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria Ituku-Ozalla, Enugu, Nigeria. 5. St Georges Hospital Memorial Centre, 6 Rasheed Alaba Williams Street, Lekki Phase 1, Lagos, Nigeria. 6. Department of Ophthalmology, Nnamdi Azikiwe University, Nnewi campus, Nigeria. 7. Department of Human Physiology, Nnamdi Azikiwe University Nnewi, Anambra State, Nigeria. 8. Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria.
Abstract
OBJECTIVES: To compare the hemoglobin and serum bilirubin concentration of term newborn following delayed and immediate umbilical cord clamping. METHODS: A randomized controlled trial of eligible parturients with singleton pregnancy delivered between July 1, 2019 and September 30, 2020 were randomly assigned (1:1 ratio) to eitherdelayed clamping of umbilical cord (60 s after delivery) or immediate clamping (0-15 s) was done. The primary outcome measures included hemoglobin and bilirubin levels of the newborn measured at birth and 48 h of life. Intention-to-treat principle was applied to analysis (www.pactr.org: PACTR201906668876480). RESULTS:One hundred and two newborns were randomized into each group and none was lost to follow-up. Participants in both groups had similar socio-demographic and clinical characteristics. At 0 h of birth, cord blood hemoglobin concentration and total bilirubin values were not significantly different between the two groups (p > 0.05). At 48 h of birth, mean hemoglobin concentration was significantly higher in delayed clamping group than immediate clamping group (16.51 ± 1.71 g/dl vs 15.16 ± 2.27 g/dl; p < 0.001) but total mean bilirubin concentration was not significantly different (3.88 ± 1.54 mg/dl vs 3.71 ± 1.20 mg/dl; p = 0.380). There was no significant difference in postpartum hemorrhage (p = 0.653), neonatal jaundice (p = 0.856), and need for phototherapy (p = 0.561) while respiratory symptoms, polycythemia and anemia were not reported. CONCLUSION: Delayed cord clamping at childbirth is more advantageous for term infants in terms of more hemoglobin concentration compared to traditional immediate cord clamping. The maternal and perinatal complications were either not significantly different or absent.
RCT Entities:
OBJECTIVES: To compare the hemoglobin and serum bilirubin concentration of term newborn following delayed and immediate umbilical cord clamping. METHODS: A randomized controlled trial of eligible parturients with singleton pregnancy delivered between July 1, 2019 and September 30, 2020 were randomly assigned (1:1 ratio) to either delayed clamping of umbilical cord (60 s after delivery) or immediate clamping (0-15 s) was done. The primary outcome measures included hemoglobin and bilirubin levels of the newborn measured at birth and 48 h of life. Intention-to-treat principle was applied to analysis (www.pactr.org: PACTR201906668876480). RESULTS: One hundred and two newborns were randomized into each group and none was lost to follow-up. Participants in both groups had similar socio-demographic and clinical characteristics. At 0 h of birth, cord blood hemoglobin concentration and total bilirubin values were not significantly different between the two groups (p > 0.05). At 48 h of birth, mean hemoglobin concentration was significantly higher in delayed clamping group than immediate clamping group (16.51 ± 1.71 g/dl vs 15.16 ± 2.27 g/dl; p < 0.001) but total mean bilirubin concentration was not significantly different (3.88 ± 1.54 mg/dl vs 3.71 ± 1.20 mg/dl; p = 0.380). There was no significant difference in postpartum hemorrhage (p = 0.653), neonatal jaundice (p = 0.856), and need for phototherapy (p = 0.561) while respiratory symptoms, polycythemia and anemia were not reported. CONCLUSION: Delayed cord clamping at childbirth is more advantageous for term infants in terms of more hemoglobin concentration compared to traditional immediate cord clamping. The maternal and perinatal complications were either not significantly different or absent.
Authors: Shiraz Badurdeen; Peter G Davis; Stuart B Hooper; Susan Donath; Georgia A Santomartino; Alissa Heng; Diana Zannino; Monsurul Hoq; C Omar F Kamlin; Stefan C Kane; Anthony Woodward; Calum T Roberts; Graeme R Polglase; Douglas A Blank Journal: PLoS Med Date: 2022-06-23 Impact factor: 11.613