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Elective caesarean: does delay in cord clamping for 30 s ensure sufficient iron stores at 4 months of age? A historical cohort control study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). Department of Research and Development, Region Halland, Sweden. (Perinatal, neonatal och barnkardiologisk forskning/Hellström-Westas)ORCID iD: 0000-0002-3972-0457
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Perinatal, neonatal och barnkardiologisk forskning/Hellström-Westas)
Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
2016 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 11, e012995Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2016. Vol. 6, no 11, e012995
National Category
Obstetrics, Gynecology and Reproductive Medicine Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-308092DOI: 10.1136/bmjopen-2016-012995ISI: 000391303400007PubMedID: 27807089OAI: oai:DiVA.org:uu-308092DiVA: diva2:1049182
Available from: 2016-11-23 Created: 2016-11-23 Last updated: 2017-02-23Bibliographically approved

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