Delayed cord clamping and haemoglobin levels in infancy: a randomised controlled trial in term babies.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
van Rheenen
Patrick
P
Department of Paediatrics, Paediatric Gastroenterology, University Medical Centre, Groningen, The Netherlands. p.f.vanrheenen@gmail.com
de Moor
Lette
L
Eschbach
Sanne
S
de Grooth
Hannah
H
Brabin
Bernard
B
D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology / Q000517:prevention & control*; D003250:Constriction; D036861:Delivery, Obstetric / Q000379:methods; D019353:Endemic Diseases; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007223:Infant; D007225:Infant Food; D007231:Infant, Newborn; D008288:Malaria / Q000097:blood / Q000453:epidemiology*; D008297:Male; D007744:Obstetric Labor Complications / Q000453:epidemiology; D011247:Pregnancy; D012423:Rural Health; D013997:Time Factors; D014470:Umbilical Cord
D006454:Hemoglobins