Effect of timing of cord clamping on neonatal venous hematocrit and clinical outcome at term–hospital based randomized control trial

The study was conducted at the department of Obstetrics and Gynecology at Jawaharlal Nehru Medical College, Aligarh India from June 2008 to October 2010. 200 mothers were selected for the study and informed consent using a predesigned proforma. The subjects were divided into 4 groups of 50 each wherein the umbilical cord was clamped at 15 seconds, 30 seconds, 1 minute and 2 minutes respectively. The neonatal venous hematocrit and clinical outcome was assessed. The primary objective was to study the effect of timing of cord clamping on neonatal venous hematocrit at 6 and 24 hours of life. The other neonatal parameters assessed were blood glucose at 6 and 24 hours, serum calcium at 6 hours, serum total bilirubin at 24 hours, oxygen saturation, temperature and duration of NICU stay. The maternal parameters studied were pre and post delivery hemoglobin, pre and post delivery hematocrit and blood loss during delivery. Data was analyzed using statistical package for social service software – SPSS version 11.5. A p value of less than 0.05 was considered statistically significant. Our study showed a rising trend in neonatal hematocrit values with progressive delay in clamping of the umbilical cord. A high indience of anemia was seen among the newborns if the cord was clamped at 15 seconds. No infant was reported to have anemia if the cord was clamped at 2 minutes. Ony asymptomatic polycythemia was seen in this category. A beneficial effect of delayed cord clamping on neonatal hematocrit at both 1 and 2 minutes but it is significantly higher at 2 minute clamping group as compared to 1 minute clamping group.