Delayed cord clamping and haemoglobin levels in infancy: a randomised controlled trial in term babies
- 27 March 2007
- journal article
- research article
- Published by Wiley in Tropical Medicine & International Health
- Vol. 12 (5), 603-616
- https://doi.org/10.1111/j.1365-3156.2007.01835.x
Abstract
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. 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. 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. 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.Keywords
This publication has 45 references indexed in Scilit:
- A practical approach to timing cord clamping in resource poor settingsBMJ, 2006
- The Zinc Protoporphyrin/Heme Ratio in Premature Infants: Has it Found its Place?The Journal of Pediatrics, 2006
- Waiting too long: low use of maternal health services in Kalabo, ZambiaTropical Medicine & International Health, 2004
- Changes in haemoglobin levels in infants in Malawi: effect of low birth weight and fetal anaemiaArchives of Disease in Childhood: Fetal & Neonatal, 2002
- Zinc Protoporphyrin/Heme Ratio for Diagnosis of Preanemic Iron DeficiencyPublished by American Academy of Pediatrics (AAP) ,1999
- Practices and beliefs of traditional birth attendants: lessons for obstetrics in the north?Tropical Medicine & International Health, 1997
- Effect of Leboyer Childbirth on Cardiac Output, Cerebral and Gastrointestinal Blood Flow Velocities in Full-Term NeonatesAmerican Journal of Perinatology, 1995
- Developmental changes in red blood cell counts and indices of infants after exclusion of iron deficiency by laboratory criteria and continuous iron supplementationThe Journal of Pediatrics, 1978
- DISTRIBUTION OF BLOOD BETWEEN INFANT AND PLACENTA AFTER BIRTHThe Lancet, 1969
- EFFECT OF GRAVITY ON PLACENTAL TRANSFUSIONThe Lancet, 1969