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Am J Perinatol 2024; 41(06): 739-746
DOI: 10.1055/a-1772-4543
Original Article

A Randomized Controlled Trial of a 30- versus a 120-Second Delay in Cord Clamping after Term Birth

Reem M. Soliman
1   Department of Pediatrics, Cairo University, Cairo, Egypt
,
Marwa M. Elgendy 
2   Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio
,
Reem N. Said
1   Department of Pediatrics, Cairo University, Cairo, Egypt
,
Bassant I. Shaarawy
1   Department of Pediatrics, Cairo University, Cairo, Egypt
,
Omneya M. Helal
3   Department of Obstetrics and Gynecology, Cairo University Obstetrics and Gynecology Hospital, Cairo, Egypt
,
Hany Aly 
2   Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio
› Author Affiliations Funding This study was registered at www.clinicaltrials.gov (identifier no.: NCT04358822).
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Abstract

Objective Delayed cord clamping (DCC) has been recently adopted in neonatal resuscitation. The immediate cardiac hemodynamic effects related to DCC more than 30 seconds was not studied. We aimed to study the effect of DCC at 120 seconds compared with 30 seconds on multiple hemodynamic variables in full-term infants using an electrical cardiometry (EC) device.

Study Design Present study is a randomized clinical trial. The study was conducted with full-term infants who were delivered at the Obstetrics and Gynecology Department in Cairo University Hospital. Sixty-eight full term infants were successfully enrolled in this trial. Cardiac output (CO) and other hemodynamic parameters were evaluated in this study by EC device. Hemoglobin, glucose, and bilirubin concentrations were measured at 24 hours. Newborn infants were assigned randomly into group 1: DCC at 30 seconds, and group 2: DCC at 120 seconds, based on the time of cord clamping.

Results Stroke volume (SV) (mL) and CO (L/min) were significantly higher in group 2 compared with group 1 at 5 minutes (6.71 vs. 5.35 and 1.09 vs. 0.75), 10 minutes (6.43 vs. 5.59 and 0.88 vs. 0.77), 15 minutes (6.45 vs. 5.60 and 0.89 vs. 0.76), and 24 hours (6.67 vs. 5.75 and 0.91vs. 0.81), respectively. Index of contractility (ICON; units) was significantly increased in group 2 at 5 minutes compared with group1 (114.2 vs. 83.8). Hematocrit (%) and total bilirubin concentrations (mg/dL) at 24 hours were significantly increased in group 2 compared with group 1 (51.5 vs. 40.5 and 3.8 vs. 2.9, respectively).

Conclusion Stroke volume and cardiac output are significantly higher in neonates with DCC at 120 seconds compared with 30 seconds that continues for the first 24 hours.

Key Points

  • CO is significantly increased with DCC at 120 seconds.

  • SV is significantly increased with DCC at 120 seconds.

  • Such effects continued during the entire 24 hours of life in full-term infants.

Keywords

cord clamping - heart rate - full-term infants - cardiac output - contractility

Authors' Contribution

R.M.S. and M.M.E. conceptualized and designed the study, interpreted the statistical analyses, drafted the initial manuscript, reviewed, and revised the manuscript; coordinated and supervised data collection; and critically reviewed the manuscript for important intellectual content. R.N.S., B.I.S., and O.M.H. interpreted the statistical analyses, drafted the initial manuscript, reviewed, and revised the manuscript; coordinated and supervised data collection; and critically reviewed the manuscript for important intellectual content. H.A. conceptualized and designed the study, performed the initial analyses, and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.


Supplementary Material



Publication History

Received: 05 December 2021

Accepted: 09 February 2022

Accepted Manuscript online:
15 February 2022

Article published online:
11 March 2022

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