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Pinzamiento tardío del cordón umbilical y niveles de hemoglobina en neonatos: ensayo aleatorizado y controlado en bebes nacidos a término
Author(s) -
Van Rheenen Patrick,
De Moor Lette,
Eschbach Sanne,
De Grooth Hannah,
Brabin Bernard
Publication year - 2007
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2007.01835.x
Subject(s) - medicine , pediatrics , odds ratio , umbilical cord , randomized controlled trial , confidence interval , malaria , cord , cord clamping , adverse effect , anemia , pregnancy , surgery , immunology , biology , genetics
Summary Objectives 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. Conclusion 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.