Anemia is a major health problem worldwide and is estimated to affect 24.8% of the global population in developed and developing countries.1 The primary cause of anemia, in 50% of cases2 is iron deficiency, which is among the most important factors which contribute to the global burden of disease.33 Recently, delaying umbilical cord-clamping has been identified as one of four effective interventions to combat iron deficiency during the first 6 months of life.6 An additional 15–40 mL of blood volume per kg of birth-weight can be delivered to the infant through the umbilical cord by allowing placental transfusion of blood to complete.7,8 This can increase total blood volume by an estimated 30–50%,7,8 thus providing an additional 30–75 mg of iron at birth.7–9 Maximizing placental transfusion of blood takes approximately 3 minutes.10
Materials and Methods: This study was conducted on 150 near term (GA - 35 to 36.6 weeks) and 150 term (GA - 37 to 42 weeks) neonates delivered without any complication with uneventful pregnancies. All the patients were randomized for the timing of cord clamping at the time of birth.
Results: Our primary outcome was the neonatal Hematocrit at 6 hrs after delivery in all the groups. The secondary outcomes were neonatal hematocrit and neonatal bilirubin at 24 and 48 hrs, and any other abnormal neonatal outcome after delivery during hospital stay, maternal blood loss at the time of delivery, maternal postnatal hemoglobin and any abnormal maternal outcome after delivery (eg. PPH) during hospital stay.
Discussion: The neonatal hematocrit levels were significantly higher in DCC groups whereas prevalence of neonatal anemia was significantly higher in ECC group. There was no significant difference in the neonatal bilirubin levels at 24 and 48 hrs, in both early and delayed cord clamping groups, in both near term and term neonates. There were no significant differences in the adverse early neonatal and maternal outcomes in both early and delayed cord clamping groups.
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