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Delayed Cord Clamping for 45 Seconds in Very Low Birth Weight Infants: Impact on Hemoglobin at Birth and Close to DischargeFunding None.
Objective To assess the impact of delayed cord clamping (DCC) for 45 seconds on hemoglobin at birth and close to discharge in very low birth weight (VLBW) infants and to compare modes of delivery in infants who received DCC.
Study Design In a retrospective study, 888 VLBW infants (≤1,500 g) who survived to discharge and received immediate cord clamping (ICC) were compared with infants who received DCC. Infants who received DCC and born via Cesarean section (C-section) were compared with those born via vaginal birth.
Results A total of 555 infants received ICC and 333 DCC. Only 188 out of 333 VLBW infants (56.5%) born during the DCC period received DCC. DCC was associated with higher hemoglobin at birth (15.9 vs. 14.9 g/dL, p = 0.001) and close to discharge (10.7 vs. 10.1 g/dL, p < 0.001) and reduced need for blood transfusion (39.4 vs. 54.9%, p < 0.001). In the DCC group, hemoglobin at birth and close to discharge was similar in infants born via C-section and vaginal birth.
Conclusion DCC for 45 seconds increased hemoglobin at birth and close to discharge and reduced need for blood transfusion in VLBW infants. DCC for 45 seconds was equally effective for infants born by C-section and vaginal delivery. Approximately 44% of VLBW infants did not receive DCC even after implementing DCC guidelines.
Studies to date have shown that DCC improves mortality and short- and long-term outcomes in VLBW infants.
No consistent guidelines for the duration of DCC in preterm and term neonates.
DCC for 45 seconds increased hemoglobin at birth and close to discharge in VLBW infants.
The authors have no financial relationships or conflict of interest relevant to this article.
B.A. conceptualized and designed the study, searched the literature, extracted and analyzed the data, and drafted the initial manuscript. N.K., O.Q., R.E., F.A., D.N., and S.S. extracted data, and reviewed and revised the manuscript. V. Bhandari, T.N., and V. Bhat critically reviewed the data analysis, and critically reviewed and revised the manuscript. Z.H.A. conceptualized and designed the study, searched the literature, analyzed the data, and critically reviewed and revised the manuscript.
All the authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.
# Current affiliation: CHOP Newborn Services at Virtua Hospital, Voorhees, NJ
Received: 04 December 2021
Accepted: 27 April 2022
Accepted Manuscript online:
06 May 2022
Article published online:
07 June 2022
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