title: Benefits of Delayed Cord Clamping in Red Blood Cell Alloimmunization.
abstract: OBJECTIVE
  Several studies have shown the benefits of delayed cord clamping (DCC) in preterm and in healthy newborns at short and long term. Our objective was to evaluate the potentials benefits and risks of DCC in red cell alloimmunization.
  
  
  METHODS
  This was a comparative before/after study of all living born neonates followed after fetal anemia requiring in utero transfusion. DCC was defined as cord clamping 30 seconds after birth.
  
  
  RESULTS
  We included a continuous series of 72 neonates: 36 without DDC (group 1) and 36 with DDC (group 2). Hemoglobin at birth was lower in group 1 (10.2 vs 13.4 g/dL, P = .0003); 7 (25%) neonates in group 1 vs 24 (70.6%) in group 2 had no anemia at birth (P = .004). The rate of transfusion was similar between the 2 groups. Postnatal exchange transfusions were more likely performed in the group without DCC than in the group with DCC (47.2% vs 19.4%, P = .0124). Delay between birth and first transfusion was higher in group 2 (0 [0-13] vs 1 [0-21], P = .0274). The maximum level of bilirubin, the rate of intensive phototherapy, and the total duration of phototherapy were similar in the 2 groups.
  
  
  CONCLUSIONS
  This study highlights a significant benefit of DCC in anemia secondary to red blood cell alloimmunization with a resulting decreased postnatal exchange transfusion needs, an improvement in the hemoglobin level at birth and longer delay between birth and first transfusion with no severe hyperbilirubinemia.
authors.affiliation: Department of Obstetrics, charles.garabedian@chru-lille.fr.
authors.forename: Charles
authors.initials: C
authors.lastname: Garabedian
authors.affiliation: Neonatology Unit, and.
authors.forename: Thameur
authors.initials: T
authors.lastname: Rakza
authors.affiliation: Department of Biostatistics, University of Lille North of France, CHRU Lille, France; and.
authors.forename: Elodie
authors.initials: E
authors.lastname: Drumez
authors.affiliation: Department of Obstetrics.
authors.forename: Marion
authors.initials: M
authors.lastname: Poleszczuk
authors.affiliation: Department of Obstetrics.
authors.forename: Louise
authors.initials: L
authors.lastname: Ghesquiere
authors.affiliation: Institute of Hematology and Transfusion, Jeanne de Flandre Hospital, CHRU of Lille, France;
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Wibaut
authors.affiliation: Department of Obstetrics.
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Depoortere
authors.affiliation: Department of Obstetrics.
authors.forename: Pascal
authors.initials: P
authors.lastname: Vaast
authors.affiliation: Neonatology Unit, and Faculty of Medicine, University of Lille North of France, CHRU Lille, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Storme
authors.affiliation: Department of Obstetrics, Faculty of Medicine, University of Lille North of France, CHRU Lille, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Houfflin-Debarge
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000097:blood / Q000276:immunology* / Q000628:therapy; D000751:Anemia, Neonatal / Q000097:blood / Q000276:immunology* / Q000628:therapy; D015551:Autoimmunity; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D003250:Constriction; D036861:Delivery, Obstetric / Q000379:methods*; D004912:Erythrocytes / Q000276:immunology*; D005078:Exchange Transfusion, Whole Blood / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011379:Prognosis; D013997:Time Factors; D014470:Umbilical Cord