Impact of stimulation among non-crying neonates with intact cord versus clamped cord on birth outcomes: observation study
Open Access
- 1 October 2021
- journal article
- research article
- Published by BMJ in BMJ Paediatrics Open
- Vol. 5 (1), e001207
- https://doi.org/10.1136/bmjpo-2021-001207
Abstract
Background Stimulation of non-crying neonates after birth can help transition to spontaneous breathing. In this study, we aim to assess the impact of intact versus clamped umbilical cord on spontaneous breathing after stimulation of non-crying neonates. Methods This is an observational study among non-crying neonates (n=3073) born in hospitals of Nepal. Non-crying neonates born vaginally at gestational age ≥34 weeks were observed for their response to stimulation with the cord intact or clamped. Obstetric characteristics of the neonates were analysed. Association of spontaneous breathing with cord management was assessed using logistic regression. Results Among non-crying neonates, 2563 received stimulation. Of these, a higher proportion of the neonates were breathing in the group with cord intact as compared with the group cord clamped (81.1% vs 68.9%, pConclusions Stimulation of non-crying neonates with intact cord was associated with more spontaneous breathing than among infants who were stimulated with cord clamped. Intact cord stimulation may help establish spontaneous breathing in apnoeic neonates, but residual confounding variables may be contributing to the findings. This study provides evidence for further controlled research to evaluate the effect of initial steps of resuscitation with cord intact.This publication has 26 references indexed in Scilit:
- Timing of cord clamping in relation to start of breathing or ventilation among depressed neonates—an observational studyBJOG: An International Journal of Obstetrics and Gynaecology, 2015
- Ventilation Onset Prior to Umbilical Cord Clamping (Physiological-Based Cord Clamping) Improves Systemic and Cerebral Oxygenation in Preterm LambsPLOS ONE, 2015
- A physiological approach to the timing of umbilical cord clamping at birthArchives of Disease in Childhood: Fetal & Neonatal, 2014
- Is It Time to Rethink Cord Management When Resuscitation Is Needed?Journal of Midwifery & Women's Health, 2014
- Intrapartum-related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990Pediatric Research, 2013
- Promoting physiologic transition at birth: Re-examining resuscitation and the timing of cord clampingSeminars in Fetal and Neonatal Medicine, 2013
- Delaying cord clamping until ventilation onset improves cardiovascular function at birth in preterm lambsJournal Of Physiology-London, 2013
- Neonatal resuscitation and immediate newborn assessment and stimulation for the prevention of neonatal deaths: a systematic review, meta-analysis and Delphi estimation of mortality effectBMC Public Health, 2011
- Regulation of the Pulmonary Circulation in the Fetus and NewbornPhysiological Reviews, 2010
- Dynamic changes in the direction of blood flow through the ductus arteriosus at birthJournal Of Physiology-London, 2009