The hematological status between early and delayed cord clamping after normal delivery in term infants at Damnoen Saduak Hospital

Objective : To compare the hematological status between early and delayed cord clamping and determine adverse outcomes 48 hours after birth Study design : A randomized controlled trial Setting : Department of Obstetrics and Gynecology, Damnoen Saduak Hospital between July 25, 2012 and December 15, 2012 Material and method : 148 singletons uncomplicated term pregnancies were selected according to inclusion criteria of this study. They were randomized to either early (at fist 10 seconds) or delayed (at 120 seconds) cord clamping after normal vaginal delivery. The infant’s venous hemoglobin, hematocrit and total mean serum bilirubin were measured at 48 hours after birth. Results : 148 term infants were selected for this study. 72 were randomized to receive early cord clamping and 76 were delayed cord clamping. At baseline two groups had similar maternal demographic characteristics. At 48 hours after delivery, the infant’s hemoglobin, and hematocrit were statistically significant higher in delayed cord clamping than early cord clamping (17.8 g/dl vs. 16.1 g/dl; p< 0.001 and 54.5% vs. 50.3%; p<0.001, respectively) The prevalence of neonatal anemia in early cord clamping was relative higher than delayed cord clamping but the difference was not statistical significant (N=11, 15.3% vs. N=4, 5.3%; p=0.08, respectively). Polycythemia and mean serum total bilirubin were relative higher in delayed cord clamping than early cord clamping however there were not statistically significant (4.0% vs. 1.4%; p=0.25 and 13.3 mg/dl vs. 12.7 mg/dl; p=0.21, respectively). There were no significant difference in Apgar score, phototherapy and maternal blood loss. Conclusion : In Term infant delayed cord clamping at 2 minutes after birth resulted in significantly increase hemoglobin, and hematocrit measured at 48 hours after birth. No difference in adverse  outcome was found  among both groups.