Elective Caesarean: Does Delay in Cord Clamping for 30 s Ensure Sufficient Iron Stores at 4 months of Age? A Historical Cohort Control Study

Overview

Journal BMJ Open

Specialty General Medicine

Date 2016 Nov 4

PMID 27807089

Citations 9

Authors

Ola Andersson

Lena Hellstrom-Westas

Magnus Domellof

Affiliations

Soon will be listed here.

Abstract

Objective: To compare iron stores in infants born after elective caesarean section (CS) and a 30 s delay of umbilical cord clamping with those born vaginally after early (≤10 s) or delayed (≥180 s) cord clamping.

Design: Prospective observational study with historical control.

Setting: Swedish county hospital.

Population: 64 infants born after elective CS were compared with a historical control of 166 early clamped and 168 delayed clamped after vaginal birth.

Methods: Blood and iron status were measured in blood samples collected at birth, 48-96 hours after birth, 4 and 12 months of age.

Primary And Secondary Outcome Measures: Ferritin at 4 months of age was the primary outcome, second outcome measures were other indicators of iron status, and haemoglobin, at 4 and 12 months of age, as well as respiratory distress at 1 and 6 hours after birth.

Results: At 4 months infants born by elective CS had better iron status than those born vaginally subjected to early cord clamping, shown by higher adjusted mean difference of ferritin concentration (39 µg/L (95% CI 10 to 60)) and mean cell volume (1.8 fL (95% CI 0.6 to 3.0)); and lower levels of transferrin receptors (-0.39 mg/L (95% CI -0.69 to -0.08)). No differences were seen between infants born after elective CS and delayed clamped vaginally born infants at 4 months. No differences were found between groups at 12 months of age.

Conclusions: Waiting to clamp the umbilical cord for 30 s after elective CS results in higher iron stores at 4 months of age compared with early cord clamping after vaginal birth, and seems to ensure iron status comparable with those achieved after 180 s delayed cord clamping after vaginal birth.

Citing Articles

Haemoglobin and red blood cell reference intervals during infancy.

Larsson S, Hellstrom-Westas L, Hillarp A, Karlsland Akeson P, Domellof M, Askelof U Arch Dis Child. 2021; 107(4):351-358.

PMID: 34674992 PMC: 8938674. DOI: 10.1136/archdischild-2021-321672.

Implementation of Delayed Cord Clamping for 3 Min During Term Cesarean Sections Does Not Influence Maternal Blood Loss.

Celen S, Horn-Oudshoorn E, Knol R, van der Wilk E, Reiss I, DeKoninck P Front Pediatr. 2021; 9:662538.

PMID: 34239848 PMC: 8257925. DOI: 10.3389/fped.2021.662538.

Effects of delayed cord clamping on neonatal jaundice, phototherapy and early hematological status in term cesarean section.

Shao H, Gao S, Lu Q, Zhao X, Hua Y, Wang X Ital J Pediatr. 2021; 47(1):115.

PMID: 34039384 PMC: 8157738. DOI: 10.1186/s13052-021-01069-6.

Erythropoietin therapy in a case of neonatal anemia after exposure to natalizumab throughout pregnancy.

Godano E, Barra F, Allodi A, Ferraiolo A, Laroni A, Novi G Ital J Pediatr. 2021; 47(1):69.

PMID: 33757559 PMC: 7987111. DOI: 10.1186/s13052-021-01025-4.

Soluble Transferrin Receptor during infancy and reference intervals for the Roche Cobas platform.

Larsson S, Hillarp A, Karlsland Akeson P, Hellstrom-Westas L, Domellof M, Askelof U Int J Lab Hematol. 2020; 43(3):378-386.

PMID: 33217104 PMC: 8246861. DOI: 10.1111/ijlh.13391.

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