Delayed Cord Clamping for 45 seconds in Very Low Birth Weight Infants: Impact on Hemoglobin at Birth and Close to Discharge

Am J Perinatol. 2022 May 6. doi: 10.1055/a-1845-1816. Online ahead of print.

Abstract

Objective: To assess the impact of delayed cord clamping (DCC) for 45 seconds on hemoglobin at birth and close to discharge in very low birthweight (VLBW) infants and to compare modes of delivery in infants who received DCC.

Study design: In a retrospective study, 888 VLBW infants (< 1500 gram) 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 g/dl vs. 14.9 g/dl, p=0.001) and close to discharge (10.7 g/dl vs 10.1 g/dl, p<0.001) and reduced need for blood transfusion (39.4% vs 54.9%, p<0.001). In 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.