BY-Tejas Desale, Ashwin More.-
Volume 1 Issue 1 (May-Aug) 2024, Article 3 (pp.21-28)
Key Points
Question: Does immediate umbilical cord clamping compared to delayed clamping affect neonatal outcomes in preterm infants?
Findings: This systematic review, including data from 12 randomized controlled trials with 1,500 preterm infants, found that delayed umbilical cord clamping significantly improves neonatal outcomes such as hemoglobin levels and reduces the incidence of intraventricular hemorrhage compared to immediate clamping. The differences observed were statistically significant.
Meaning: Delayed umbilical cord clamping in preterm infants is associated with better neonatal outcomes, indicating it may be a preferred practice to enhance infant health.
Abstract
Importance:
The timing of umbilical cord clamping in preterm infants is a critical practice with significant implications for neonatal health outcomes. Immediate versus delayed clamping has been debated, with potential impacts on infant physiology and morbidity.
Objective:
This systematic review aims to evaluate and compare the effects of immediate versus delayed umbilical cord clamping on neonatal outcomes in preterm infants. The review focuses on the implications of clamping timing for clinical outcomes such as hemoglobin levels, incidence of intraventricular hemorrhage, and overall neonatal health.
Evidence Review:
A comprehensive literature search was conducted across several databases, including PubMed, Embase, and Cochrane Library, covering studies published from January 2000 to December 2023. The search strategy included terms related to umbilical cord clamping and preterm infants. Reference lists from selected articles were also reviewed for additional relevant studies. Studies meeting predefined inclusion criteria were assessed for methodological quality using the Cochrane Risk of Bias tool. Both randomized controlled trials and observational studies were considered.
Findings:
The review included 12 randomized controlled trials with a total of 1,500 participants. The evidence indicates that delayed umbilical cord clamping leads to significant improvements in neonatal outcomes, including higher hemoglobin levels and a lower incidence of intraventricular hemorrhage, compared to immediate clamping. These findings are supported by high-quality evidence with statistically significant results.
Conclusions and Relevance:
The review concludes that delayed umbilical cord clamping is associated with more favorable neonatal outcomes in preterm infants. This practice should be considered as a preferred approach in neonatal care to enhance infant health and reduce complications. The findings suggest that implementing delayed clamping could improve clinical protocols and contribute to better management practices for preterm infants.
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