EC Paediatrics

Background: Neonatal iron deficiency anemia (IDA) is an important problem that has multiple sequelae to long-term cognitive, emotional, and behavioral development of new-borne. Delayed cord clamping (DCC) can protect against neonatal IDA in neonates by transferring residual blood in the placenta. This practice is easy, effective and without cost [1,2]. Hyperbilirubinemia is considered a potential disadvantage of DCC, while in practice, it does not appear to be associated with increased phototherapeutic demand [3-5]. This study was conducted to observe the hematological improvement like Hemoglobin and hematocrit levels in a term neonate who underwent delayed cord clamping without requirement of phototherapy for neonatal jaundice.

Methods: Randomized control study was performed in a tertiary care teaching hospital Bagalkot between January 2021 and May 2022 after obtaining informed consent and institutional ethical committee clearance among those who fulfilled the inclusion and exclusion criteria. Patient were the term neonates born by caesarean section in OBG department, HSK hospital based on inclusion/exclusion criteria.

Venous samples were tested for hematocrit and hemoglobin at 48hrs of life. Transcutaneous bilirubin (TcB) screening levels were estimated who were found clinically icteric on day 3 of life, if TcB levels were high, venous sample for serum bilirubin level were estimated.

Results: Mean hematocrit in DCC group was higher than in ECC group [58.9 (5.5) vs 47.14 (5.8) P < 0.05]. Mean hemoglobin in DCC was higher than in ECC group [19.59 (1.41) vs 16.7 (1.3) P < 0.05]. Rate of phototherapy was 13.5% in ECC and 11.8% in DCC group. DCC at 30 - 60 seconds resulted in the higher neonatal hemoglobin level on day 3 without a higher rate of phototherapy (P value > 0.05).

Conclusion: In caesarean section, delayed cord clamping for 30 - 60s improved the early hematological status of term neonates without the enhanced requirement of phototherapy for neonatal jaundice. DCC at 30 - 60 sec is simple, effective and safe procedure that can be recommended in term C-section in preventing IDA.

Keywords: Anemia; Caesarean Section; Delayed Cord Clamping; Early Cord Clamping; Neonatal Jaundice; Phototherapy

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