Comparison between the Effects of Early and Delayed Cord Clamping in Preterm Infants in Suez Canal University Hospital

Objectives: This study was designed to compare the short and long term impacts of early versus delayed clamping of umbilical cord at birth on preterm infants. Patients and Methods: The study was a comparative cross sectional study carried out on 46 preterm infants born in the obstetrics and gynecology department and followed up in the neonatology unit of Suez Canal University hospital. 23 of these 46 preterm infants were with early cord clamping (cord clamping immediately after delivery within 5 seconds), while the other 23 preterm infants were with delayed cord clamping (cord clamping within 30-120 seconds). Inclusion criteria were: Preterm infants with gestational age 28-37 weeks; delivered by vaginal delivery or cesarean section and singleton pregnancies. Any preterm infants with complications (as IUGR, fetal malformations, or RH incompatibility) or multiple pregnancies were excluded from the study. At the obstetrics and gynecology department all women were assessed clinically and laboratory by pre and post delivery CBC and also clinical assessment of neonates using Apgar score. At neonatal intensive care unit all neonates were followed for: 1) anemia by hema- tocrit level, 2) hyperbilirubinemia in the first three days of life, 3) for RDS clinically, radiologically and laboratory, 4) Intra-Ventricular Hemorrhage IVH using cranial ultrasound at six and 72 hours after delivery 5) Necrotizing Entero-Colitis NEC using Bell staging criteria. Results: Both groups were matched regarding gestational age, type of delivery and consanguinity. No statistically significant difference were reported in terms of incidence of hyperbilirubinemia, results of cranial US at 6 and 72 hours after delivery, need for mechanical ventilation and incidence of NEC (p-value 0.05). Statistically significant differences were reported regarding hematocrit values and need for blood transfusion as well as incidence of RDS. Difference between pre and post deliver Hb% were statistically significant in ECC group unlike DCC group, however, difference between pre delivery Hb% in ECC and DCC groups was not statistically significant and so was difference between post delivery Hb% in both groups. Conclusion: Delaying clamping of the umbilical cord in preterm neonates for (30-120) seconds following birth is beneficial to the newborn, as it reduced the anemia of preterm, periventricular-intraventricular hemorrhage (PVH-IVH), respiratory distress syndrome (RDS) and has no deleterious effect on the mother.