Timing of Umbilical Cord Clamping in Preterm Neonates: A Randomized Controlled Trial

Autor: Fatma Zaghloul Mahmoud, Samar Mahmoud Mohamed Elhadary, Mona M Ebrahim Abd Elnabi, Fatma M Atta, Marwa Abd Elkreem, Lawahez M. Dwedar
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Sudan Journal of Medical Sciences, Vol 19, Iss 2, Pp 211-223 (2024)
Druh dokumentu: article
ISSN: 1858-5051
DOI: 10.18502/sjms.v19i2.14520
Popis: Abstract Background: The optimal timing for clamping the umbilical cord remains controversial. This study aimed to assess the optimal timing of umbilical cord clamping and its effect on preterm neonates. Methods: The study was a randomized controlled trial with the registration number: NCT06000800. It was conducted at Kasr Al Ainy Maternity Hospital, Cairo University Hospital, where a total of 80 pregnant women were randomly pooled and randomly divided into four groups with each group comprising 20 pregnant women. Umbilical cord clamping was performed in the first group immediately (5 sec after birth), after 30 sec in the second group, after 60 sec in the third group, and after 90 sec in the fourth group. After birth, clinical and laboratory parameters were assessed and recorded at the 1 st , 6 th , 12 th , 24 th , and 48 th hours for all preterm neonates. Results: Delayed cord clamping at 90 sec was linked to improved preterm neonatal outcomes including heart rate at the 1 st and the 6 th hours; respiratory rate at the 12 th hour; oxygen saturation at the 1 st hour; hemoglobin, hematocrit, and blood glucose levels at the 6 th , 12 th , 24 th , and 48 th hours; but also linked to increase in bilirubin levels at the 12 th , 24 th , and 48 t h hours (P < 0.001). There was no statistically significant difference concerning APGAR score; respiratory rate at the 12 t h hour, temperature at the 1 st , 6 th , 12 th , 24 th , and 48 th hours; hemoglobin, hematocrit, and blood glucose at the 1 st hour; and bilirubin at the 1 st , 6 th , and 12 th hours in all groups (5, 30, 60, and 90 sec) (P > 0.05). Conclusion: Better levels of blood glucose and hemoglobin were seen in preterm neonates whose cord clamping was delayed. Further studies should be carried out to determine the optimal timing of umbilical cord clamping with larger samples, for extended delay of clamping for more than 90 sec, and with recording of parameters for an extended period of follow-up even past the neonatal period.
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