title: Delayed cord clamping in South African neonates with expected low birthweight: a randomised controlled trial.
abstract: OBJECTIVE
  To evaluate safety and haematological effects of delayed cord clamping (DCC) in infants with expected low birthweight born in a resource-poor setting.
  
  
  METHODS
  Randomised controlled trial involving pregnant women in early labour ≥18 years with intrapartum symphysal-fundal height ≤32 cm. Mothers were randomised for either early cord clamping (ECC, <30 s) or DCC (2-3 min after birth).
  
  
  RESULTS
  We included 104 vigorous infants born by vaginal delivery, of whom 39% had a birthweight <2500 g. Infant haemoglobin (Hb) levels 24 h after birth were significantly higher in the DCC group (18.0 g/dl vs. 16.8 g/dl, P = 0.006). Despite successful placental transfusion, hyperbilirubinemia and hyperviscosity were not observed. Two months after birth, there were no differences in Hb between groups (9.9 g/dl vs. 9.8 g/dl, P = 0.60), but the infants in the DCC group had better weight gain from baseline than those with ECC (2.2 kg vs. 1.9 kg, P = 0.058).
  
  
  CONCLUSIONS
  In this South African cohort of newborns with a subnormal distribution of birthweight delayed cord clamping was a safe procedure. Two months after birth the effect of DCC on Hb was not detectable anymore. DCC should be promoted in every singleton delivery in a resource-poor setting irrespective of the birthweight.
authors.affiliation: Department of Paediatrics, University of Groningen, Groningen, The Netherlands; Department of Paediatrics, Stanger Hospital, KwaZulu-Natal, South Africa.
authors.forename: Sybrich
authors.initials: S
authors.lastname: Tiemersma
authors.forename: Julia
authors.initials: J
authors.lastname: Heistein
authors.forename: Roos
authors.initials: R
authors.lastname: Ruijne
authors.forename: Gustavo
authors.initials: G
authors.lastname: Lopez
authors.forename: Jeroen
authors.initials: J
authors.lastname: van Lobenstein
authors.forename: Patrick
authors.initials: P
authors.lastname: van Rheenen
mesh_terms: D000293:Adolescent; D000328:Adult; D003250:Constriction; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D013019:South Africa; D013997:Time Factors; D016896:Treatment Outcome; D014470:Umbilical Cord; D055815:Young Adult
chemical_list: D006454:Hemoglobins
keywords: anaemia; anemia; anémie; bajo peso al nacer; clampage du cordon; cord clamping; haematology; hematología; hématologie; low birthweight infants; neonatos; nourrissons de faible poids de naissance; pinzamiento del cordón