Background: The timing of umbilical cord clamping remains a subject of ongoing debate in obstetric practice. Delayed cord clamping has been associated with improved neonatal iron stores, while concerns exist regarding potential adverse effects on both maternal and neonatal outcomes.
Objective: To compare the effects of early versus delayed cord clamping on neonatal and maternal outcomes in term deliveries at a tertiary care center.
Methods: This prospective observational study included 100 term deliveries (37-42 weeks) equally divided into early cord clamping (ECC, clamping within 30 seconds) and delayed cord clamping (DCC, clamping after 60 seconds) groups. Primary outcomes included neonatal hemoglobin, hematocrit, serum bilirubin levels, and incidence of anemia. Secondary outcomes assessed maternal blood loss and postpartum hemorrhage. Statistical analysis was performed using independent t-tests and Chi-square tests.
Results: The DCC group demonstrated significantly higher hemoglobin levels (16.2±1.4 vs. 14.1±1.2 g/dL, p<0.001) and hematocrit values (47.1±4.2 vs. 42.5±3.8%, p<0.001) compared to the ECC group. Neonatal anemia incidence was significantly reduced in the DCC group (4% vs. 16%, p=0.04). No significant differences were observed in serum bilirubin levels, polycythemia, NICU admissions, or blood transfusion requirements. Maternal outcomes, including blood loss (366±68 vs. 356±72 ml, p=0.44) and postpartum hemorrhage incidence (6% vs. 4%, p=0.64), were comparable between groups.
Conclusion: Delayed cord clamping significantly improves neonatal hematological parameters and reduces anemia without increasing maternal or neonatal complications. It should be adopted as standard practice in uncomplicated term deliveries.
International Journal of Clinical Obstetrics and Gynaecology
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