Effect of Delayed Versus Early Cord Clamping on Improving Anemia in Term Infants Aged Two Months or Older — A Meta-analysis

2020 ◽  
Vol 57 (9) ◽  
pp. 815-819
Author(s):  
Xin Fu ◽  
Dan Dang ◽  
Siwen Li ◽  
Zhiyan Xu ◽  
Hui Wu
Keyword(s):  
Meta Analysis ◽  
Term Infants ◽  
Cord Clamping ◽  
Early Cord Clamping

Increment in Phototherapy After Adopting Delayed Cord Clamping Practice

2021 ◽  
pp. 097321792110607
Author(s):  
Chinmay Chetan ◽  
Nishant Banait ◽  
Vikramaditya Athelli ◽  
Bhvya Gupta ◽  
Prince Pareek ◽  
...  
Keyword(s):  
Tertiary Care ◽  
World Health ◽  
Care Hospital ◽  
Delayed Cord Clamping ◽  
Term Infants ◽  
Cord Clamping ◽  
Early Cord Clamping ◽  
Baseline Characteristics ◽  
Health Organization ◽  
Larger Sample

Introduction: World Health Organization (WHO) in 2014 recommended delayed cord clamping (DCC) in all babies who cry immediately after birth. Despite many benefits, there are concerns of increased rate of phototherapy in babies receiving DCC. This study was done to determine the increment in the rate of phototherapy required in infants managed with DCC vs infants managed with early cord clamping (ECC). Methods: A retrospective observational study was conducted in a tertiary care hospital in Pune, India. All the infants born between January 2018 and July 2018, for whom ECC was done, were compared with infants who were born between January 2019 and July 2019, after DCC policy was adopted. All the infants with birth weight ≥2 kg and gestation ≥35 weeks, who were with their mother, were included. Baseline characteristics were compared for both the groups. American Academy of Pediatrics guidelines for treatment of neonatal jaundice were used to determine the need for phototherapy. Number of infants in both the groups who required phototherapy were compared. Results: The ECC group had 565 infants while DCC group had 731 infants. There was no difference in the baseline characteristics of the 2 groups. Jaundice requiring phototherapy was noted in 31% of infants in the ECC group, compared to 45% in infants in the DCC group (relative risk: 1.47 [1.27-1.71] [ P < .001]). Conclusion: In this study, DCC increased the need for phototherapy by 47% in late preterm and term infants. Randomized control trials with larger sample size are required to confirm this finding.

scholarly journals Delayed cord clamping for prevention of iron deficiency anemia in term infants

2012 ◽  
Vol 52 (4) ◽  
pp. 223
Author(s):  
Olga Rasiyanti Siregar ◽  
Bugis Lubis ◽  
Muara Lubis ◽  
Bidasari Lubis ◽  
Guslihan Dasa Tjipta
Keyword(s):  
Iron Deficiency ◽  
Iron Status ◽  
Ferritin Level ◽  
Newborn Infants ◽  
Deficiency Anemia ◽  
Delayed Cord Clamping ◽  
Term Infants ◽  
Cord Clamping ◽  
Early Cord Clamping ◽  
Umbilical Cords

Background Iron deficiency childhood is a concern due to its potentially detrimental effectson development, some of which may be irreversible even after irontreatment. Delayed cord clamping may prevent IDA by increasingan infant's iron reserve at birth.Objective We aimed to evaluate the effect of delayed umbilicalcord clamping at birth on the iron status in newborns at age 24hours of life.Methods This randomized, single􀁒blind study was conducted fromMarch to May 2009, at two general hospitals in Medan, NorthSumatera Province. Eligible newborn infants were randomlyassigned to one of two groups: early cord clamping (Eee)performed 15 seconds after delivery or delayed cord clamping(DeC) performed 2 minutes after delivery. Infants were placed ontheir mothers' abdomens before the umbilical cords were clamped.Hematologic status was determined from umbilical cord blood.Results Sixty􀁒three subjects were included in our study, consistingof31 infants in the Eee group and 32 infants in the Dec group.We found that mean neonatal hemoglobin level was higher inthe Dec group than in the Eee group ( 18.4 g% and 16.2 g%,respectively, P=O.OOOl). Also, mean ferritin level was higher inthe Dec group than in the Eee group (556 mg/dL and 329 mg/dL, respectively, p=o.o 15). Other hematological status indicators,including mean hematocrit and mean corpuscular volume (MeV)level, were also higher in the Dec group. However, mean redblood cell levels were not significantly groups. Nor was there a significant level between the Dec and Eee groups.Concl usion Dela y ed cord c l a m p i n g m a y improve ironstatus and prevent IDA in term infants. [Paediatr Indones.2012;52:223-8].

scholarly journals Does Delayed Cord Clamping Improve Long-Term (≥4 Months) Neurodevelopment in Term Babies? A Systematic Review and a Meta-Analysis of Randomized Clinical Trials

2021 ◽  
Vol 9 ◽  
Author(s):  
Serena Xodo ◽  
Luigi Xodo ◽  
Giovanni Baccarini ◽  
Lorenza Driul ◽  
Ambrogio P. Londero
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Hematological Parameters ◽  
Pooled Analysis ◽  
Delayed Cord Clamping ◽  
Term Infants ◽  
Cord Clamping

Background: Recently, the literature suggested that placental transfusion facilitated by delayed cord clamping (DCC), besides having benefits on hematological parameters, might improve the infants' brain development.Objective: The present review primarily evaluates the Ages and Stages Questionnaire (ASQ) total score mean difference (MD) at long-term follow-up (≥4 months) comparing DCC (&gt;90 or &gt;180 s) to early cord clamping (ECC). Secondary aims consisted of evaluating the ASQ domains' MD and the results obtained from other methods adopted to evaluate the infants' neurodevelopment.Methods: MEDLINE, Scopus, Cochrane, and ClinicalTrials.gov databases were searched (up to 2nd November 2020) for systematic review and meta-analysis. All randomized controlled trials (RCTs) of term singleton gestations received DCC or ECC. Multiple pregnancies, pre-term delivery, non-randomized studies, and articles in languages other than English were excluded. The included studies were assessed for bias and quality. ASQ data were pooled stratified by time to follow up.Results: This meta-analysis of 4 articles from 3 RCTs includes 765 infants with four-month follow-up and 672 with 12 months follow-up. Primary aim (ASQ total score) pooled analysis was possible only for 12 months follow-up, and no differences were found between DCC and ECC (MD 1.1; CI 95: −5.1; 7.3). DCC approach significantly improves infants' communication domains (MD 0.6; CI 95: 0.1; 1.1) and personal-social assessed (MD 1.0; CI 95: 0.3; 1.6) through ASQ at 12 months follow-up. Surprisingly, the four-month ASQ personal social domain (MD −1.6; CI 95: −2.8; −0.4) seems to be significantly lower in the DCC group than in the ECC group.Conclusions: DCC, a simple, non-interventional, and cost-effective approach, might improve the long-term infants' neurological outcome. Single-blinding and limited studies number were the main limitations. Further research should be performed to confirm these observations, ideally with RCTs adopting standard methods to assess infants' neurodevelopment.Trial registration: NCT01245296, NCT01581489, NCT02222805, NCT01620008, IRCT201702066807N19, and NCT02727517

Comparison of Three Different Cord Clamping Techniques Regarding Oxidative-antioxidative Capacity in Term Newborns

2022 ◽  
Author(s):  
Ishak Kartal ◽  
Aslihan Abbasoglu ◽  
Seyithan Taysi
Keyword(s):  
Apgar Score ◽  
Antioxidant Status ◽  
Delayed Cord Clamping ◽  
Future Health ◽  
Term Infants ◽  
Uncomplicated Pregnancy ◽  
Cord Clamping ◽  
Early Cord Clamping ◽  
Total Antioxidant ◽  
Term Newborns

Objective As newborns are exposed to oxidative stress during delivery, cord clamping techniques play significant role on antioxidant status. In this study, we aimed to show the relationship between early cord clamping (ECC), delayed cord clamping (DCC) and cut umblical cord milking (C-UCM) techniques with total oxidant capacity (TOC), total antioxidant capacity (TAC) and peroxynitrite levels. Study Design Sixty-nine term infants were selected with APGAR score of 7 and above in the first and fifth minutes. The mothers of all infants had uncomplicated pregnancy, had no congenital anomaly, and delivered by cesarean section. Newborns were randomised to one of three groups: ECC (n: 23), DCC (n: 23) or C-UCM (n: 23). After all newborn babies were taken under radiant heater, blood samples were collected from the umbilical cord. The plasma samples were then frozen and stored at -80 °C until analysis and TOC, TAC and peroxynitrite levels were studied. Results The ages of the mothers participating in the study were between 17 and 42, with an average of 29.14 ± 6.28. 30 (43.5%) of the babies were girls and 39 (56.5%) were boys. The 5th minute APGAR score of the babies in early cord clamping group was significantly lower than the babies in delayed cord clamping and cut cord milking group (p = 0.034; p = 0.034; p <0.05). The TOC, OSI and Peroxynitrite measurements of three groups did not differ statistically. The TAC value of the C-UCM group was significantly higher than the patients with the ECC and DCC group (p = 0.002; p = 0.019; p <0.05). Conclusion C-UCM and DCC would be feasible methods by increasing antioxidant status and providing protective effect on the future health of the term newborns,

scholarly journals Erythropoietin monotherapy for neuroprotection after neonatal encephalopathy in low-to-middle income countries: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Phoebe Ivain ◽  
Paolo Montaldo ◽  
Aamir Khan ◽  
Ramyia Elagovan ◽  
Constance Burgod ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Neonatal Encephalopathy ◽  
Neurodevelopmental Outcomes ◽  
Term Infants ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pooled Data ◽  
Risk Of Death ◽  
Low Middle Income Countries ◽  
Near Term

Abstract Objective We examined whether erythropoietin monotherapy improves neurodevelopmental outcomes in near-term and term infants with neonatal encephalopathy (NE) in low-middle income countries (LMICs). Methods We searched Pubmed, Embase, and Web of Science databases to identify studies that used erythropoietin (1500–12,500 units/kg/dose) or a derivative to treat NE. Results Five studies, with a total of 348 infants in LMICs, were retrieved. However, only three of the five studies met the primary outcome of death or neuro-disability at 18 months of age or later. Erythropoietin reduced the risk of death (during the neonatal period and at follow-up) or neuro-disability at 18 months or later (p < 0.05). Death or neuro-disability occurred in 27.6% of the erythropoietin group and 49.7% of the comparison group (risk ratio 0.56 (95% CI: 0.42–0.75)). Conclusion The pooled data suggest that erythropoietin monotherapy may improve outcomes after NE in LMICs where therapeutic hypothermia is not available.

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