Am J Perinatol
DOI: 10.1055/s-0039-1688982
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Is Delaying Cord Clamping until Placenta Delivery Beneficial? Oxygen Saturation and Heart Rate Transition during the Initial 5 Minutes after Delivery in Indian Healthy Newborns

Suchandra Mukherjee
1  Department of Neonatology, Institute of Post Graduate Medical Education & Research, Kolkata, West Bengal, India
,
Jignesh S. Bulsara
2  Department of Obstetrics and Gynaecology, Shreemad Rajchandra Hospital, Dharampur, Valsad, Gujarat, India
,
Manoja Kumar Das
3  The INCLEN Trust International, New Delhi, India
,
Yogendra Waratakar
4  Department of Pediatrics, Shreemad Rajchandra Hospital, Dharampur, Valsad, Gujarat, India
,
Anindya Kumar Saha
1  Department of Neonatology, Institute of Post Graduate Medical Education & Research, Kolkata, West Bengal, India
,
Sunil Dubey
5  Medical Administration, Shreemad Rajchandra Hospital, Dharampur, Valsad, Gujarat, India
,
Pratima Mehta
5  Medical Administration, Shreemad Rajchandra Hospital, Dharampur, Valsad, Gujarat, India
,
Bini Gupta
3  The INCLEN Trust International, New Delhi, India
,
Arun K. Singh
6  Rashtriya Bal Swasthya Karyakram, Ministry of Health & Family Welfare, Government of India, New Delhi, India
,
for Indian Delayed Cord Clamp Study Group› Author Affiliations
Funding None.
Further Information

Publication History

12 December 2018

07 April 2019

Publication Date:
30 May 2019 (online)

Abstract

Objective To compare the preductal oxygen saturation (SpO2) and heart rate (HR) in newborns during the initial 5 minutes after birth with delayed cord clamping (DCC) and early cord clamping (ECC) practices at sea level.

Study Design This prospective observational study included newborns born at >34 weeks vaginally (Dharampur, Gujarat) or through caesarean section (CS) (Kolkata, West Bengal). In Dharampur, the newborns received ECC practice (8 weeks) followed by DCC practice (10 weeks). In Kolkata, the newborns received ECC practice only (8 weeks).

Results The newborns with DCC (n = 170) had significantly higher SpO2 (3–8%) throughout than those with ECC born either vaginally (n = 178) or through CS (n = 101). The newborns with DCC had slower rise in HR during the first 2 minutes than those with ECC. The 5th and 10th percentile values of SpO2 for newborns with DCC practice were higher than those with ECC practice.

Conclusion The trends of SpO2 and HR during the first 5 minutes after birth indicate a relatively smoother cardiopulmonary transition by delaying cord clamping till placental delivery compared with early clamping. The reference ranges can be used for Indian newborns born by uncomplicated vaginal delivery with DCC during the first 5 minutes.

Authors' Contributions

A.K.S., A.S., S.M. and M.K.D. conceptualized the study. J.S.S., Y.W., S.D., P.M., A.S., and S.M. implemented and collected the data. M.K.D., B.G., A.S., and A.K.S. undertook data analysis. M.K.D. and A.K.S. drafted the manuscript. All authors reviewed and approved the manuscript.


Ethical Approval

This project was approved by the Ethics Committee at the Institute of Postgraduate Medical Education and Research, Kolkata.


Supplementary Material