Meta-Analysis the Effect of Cord Clamping Time on Hemoglobin Elevation in Newborn Infants

Authors

  • Rynda Arum Dilafa Master's Program in Public Health, Universitas Sebelas Maret
  • Setyo Sri Rahardjo Faculty of Medicine, Universitas Sebelas Maret
  • Bhisma Murti Master's Program in Public Health, Universitas Sebelas Maret

DOI:

https://doi.org/10.26911/thejmch.2023.08.03.09

Abstract

Background: Fulfillment of iron needs is very important in the first 1000 days of human life, with sufficient amounts of iron can determine the quality of life in the future, to produce a healthy and quality generation. Delaying clamping and cutting the umbilical cord for about 1-2 minutes can increase the amount of blood flowing to the newborn so as to prevent low hemoglobin in the neonatal period. This study aims to analyze the effect of delayed cord cutting on hemoglobin levels in newborns.

Subjects and Method: This study was a systematic study and meta-analysis, with the following PICO Population= term newborn at 48 hours after birth. Intervention= Time delay of clamping the umbilical cord (≤60 seconds). Comparison= Immediate cord clamping time (≤15 seconds). Outcome= Hemoglobin Level. The articles used in this study were obtained from several databases including PubMed, Science Direct and Google Scholar. The keywords used were: “umbilical cord and infant”, “Delayed Cord Clamping”, “Delayed Cord Clamping and Immediate Cord Clamping” “DCC and Hemoglobin “DCC and Anaemia”. Inclusion criteria were full-text articles of randomized controlled experimental study design. trial (RCT) Articles were collected using PRISMA flow diagrams Articles were analyzed using the Review Manager 5.3 application.

Results: Based on the results of a meta-analysis of 9 primary studies on the effect of cord clamping time on increasing newborn hemoglobin levels originating from Pakistan, China, Thailand, India, Bangladesh, the United States, and Nigeria, it can be concluded that delayed cord clamping in newborns birth increased the hemoglobin level by 0.81 units compared to clamping the cord immediately after birth, and this result was statistically significant (SMD= 0.81; 95% CI= 0.30 to 1.32; p=0.002).

Conclusion: Delay in cutting the umbilical cord can increase hemoglobin in full-term newborns without indications.

Keywords: delayed cord clamping, hemoglobin.

Correspondence: Rynda Arum Dilafa. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: ryndaarumd@gmail.com. Mobile: +6285­852358033

 

References

Akram A, Rehman T, Aziz S (2017). To compare the iron status of new borns `borns` 48 hours after birth in delayed versus early umbilical cord clamping. Journal of the Society of Obstetrics and Gynaecologists of Pakistan (JSOGP). 7(2): 71–75.

Astuti DP, Indriyastuti HI, Novyriana E (2018). Penundaan penjepitan tali pusat terhadap kadar bilirubin bayi baru lahir (Delay in umbilical cord clamping on bilirubin levels in newborns). Journal of Health Sciences. 11(2): 177–182.

Briawan D (2014). Anemia: masalah gizi pada remaja wanita. (Anemia: a nutritional problem in young women), in. EGC.

Buckley SJ (2011). Leaving well alone in the third stage of labour, Midwifery today with international midwife, (100): 30–32.

Ceriani Cernadas JM, Carroli G, Pellegrini, L, Otaño L, Ferreira M, Ricci C, Casas O, Giordano D, Lardizábal J (2006). The effect of timing of cord clamping on neonatal venous hematocrit values and clinical outcome at term: a randomized, controlled trial. Pediatrics, 117(4): e779–e786.

Erickson ODA, Mercer JS, Oh W (2012). Umbilical cord milking in term infants delivered by caesarean section: A randomized controlled trial. Journal of Perinatology. 32(8): 580–584. https://doi.org/10.1038/jp.2011.159

Garabedian C, Rakza T, Drumez E, Poleszczuk M, Ghesquiere L, Wibaut B, Depoortere MH, Vaast P, Storme L, Houfflin-Debarge V (2016). Benefits ofdelayed cord clamping in red blood cell alloimmunization. American Academy of Pediatrics. 137(3).

Hutchon DJR (2012). Immediate or early cord clamping vs delayed clamping’, Journal of Obstetrics and Gynaecology. Taylor & Francis 32(8): 724–729.

Jaiswal P, Upadhyay A, Gothwal S, Singh D, Dubey K, Garg A, Vishnubhatala S (2015). Comparison of two types of intervention to enhance placental redistribution in term infants: randomized control trial. European Journal of Pediatrics, 174(9): 1159–1167. Doi: https://doi.org/10.1007/s004310152511y

Lozoff B, Georgieff MK (2006). Iron deficiency and brain development, Seminars in Pediatric Neurology, 13(3): 158–165. doi: https://doi.org/10.1016/j.spen.2006.08.004.

Lubis MP (2008). Dampak penundaan pengkleman tali pusat terhadap peningkatan hemoglobin dan hematokrit bayi pada persalinan normal (The impact of delayed cord clamping on increased hemoglobin and infant hematocrit in normal delivery). Universitas Sumatera Utara.

Mercer JS, Erickson-Owens DA, Collins J, Barcelos MO, Parker AB, Padbury JF (2016). Effects of delayed cord clam-ping on residual placental blood volume, hemoglobin and bilirubin levels in term infants: A randomized controlled trial. Journal of Perinatology. Nature Publishing Group. 37(3): 260–264. doi: 10.1038/jp.2016.222.

Mercer JS, Erickson ODA, Deoni SCL, Dean DC, Tucker R, Parker AB, Joelson S, Mercer EN, Collins J, Padbury JF, et al (2020). The effects of delayed cord clamping on 12-month brain myelin content and neurodevelopment: a randomized controlled trial. American Journal of Perinatology. 39(1): 37–44. Doi: 10.1055/s00401714258.

Mitra U, Shahidullah M, Mannan A, Nahar Z, Dey SK, Mannan I (2009). Timing of Cord Clamping and it’s Effect on Haematocrit and Clinical Outcome of Neonate. Bangladesh Journal of Child Health. 33(1):16–21. Doi: https://doi.org/10.3329/bjch.v33i1.5670

Ofojebe CJ, Eleje GU, Ikechebelu JI, Okpala BC, Ofojebe BA, Ugwu EO, Igbodike EP, Onwuegbuna AA, Ikwuka DC, Anikwe CC, Ejikeme TB (2021). A randomized controlled clinical trial on peripartum effects of delayed versus immediate umbilical cord clamping on term newborns. European Journal of Obstetrics and Gynecology and Reproductive Biology. Elsevier Ireland Ltd, 262: 99–104. doi: 10.1016/j.ejogrb.2021.-04.038

Organization WH (2012). Guidelines on basic newborn resuscitation. World Health Organization.

Shao H, Gao S, Lu Q, Zhao X, Hua Y, Wang X (2021). Effects of delayed cord clamping on neonatal jaundice, phototherapy and early hematological status in term cesarean section. Italian Journal of Pediatrics. 47(1): 1–7. Doi: https://doi.org/10.1186/s13052021010696

Songthamwat M, Witsawapaisan P, Tanthawat S, Songthamwat S (2020). Effect of delayed cord clamping at 30 seconds and 1 minute on neonatal hematocrit in term cesarean delivery: a randomized trial’, International Journal of Women’s Health. Dove Press, 12, p. 481.

Tanmoun N (2013). The hematological status between early and delayed cord clamping after normal delivery in term infants at Damnoen Saduak Hospital. Thai Journal of Obstetrics and Gynaecology. 21(2): 63–71. Retrieved from: https://he02.tcithaijo.org/index.php/tjog/article/view/8554.

Tolosa JN, Park D, Eve DJ, Klasko SK, Borlongan CV, Sanberg PR (2010). Mankind’s first natural stem cell transplant. Journal of cellular and molecular medicine. Wiley Online Library. 14(3): 488–495.

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Published

2023-05-16

How to Cite

Dilafa, R. A., Rahardjo, S. S., & Murti, B. (2023). Meta-Analysis the Effect of Cord Clamping Time on Hemoglobin Elevation in Newborn Infants . Journal of Maternal and Child Health, 8(3), 347–355. https://doi.org/10.26911/thejmch.2023.08.03.09

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