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Published on: May 10, 2022
[Timing of clamping and factors associated with iron stores in full-term newborns]
Insights
Delayed umbilical cord clamping and socioeconomic factors significantly impact newborn iron stores. Policies addressing social inequalities and improving antenatal care are crucial for preventing infant anemia.
Area of Science:
- Neonatal Hematology
- Perinatal Medicine
- Public Health Nutrition
Context:
- Newborn iron stores are critical for development and are influenced by various factors.
- Umbilical cord clamping timing is a modifiable factor with potential implications for iron transfer.
- Socioeconomic and obstetric factors also play a role in neonatal iron status.
Purpose:
- To investigate the influence of umbilical cord clamping timing, and obstetric, biological, and socioeconomic factors on the iron stores of full-term newborns.
- To analyze the relationship between these factors and ferritin levels at birth.
Summary:
- A cross-sectional study evaluated 144 full-term newborns in Brazil, measuring hematological parameters and umbilical cord clamping time.
- Bivariate analysis showed associations between ferritin levels and child's color, 60-second clamping, delivery type, gestational diabetes, and family income.
- Multivariate analysis identified per capita income, antenatal visits, and birth length as significant predictors of ferritin levels, accounting for 22.0% of the variation.
Impact:
- Findings highlight that iron stores at birth are multifactorial, influenced by biological, obstetric, and social determinants.
- Recommendations include policy development to reduce social inequalities, enhance antenatal care quality, and adopt delayed umbilical cord clamping.
- These interventions are essential for effective anemia prevention strategies in newborns.
Objective:
To analyze the impact of timing of clamping and obstetric, biological and socioeconomic factors on the iron stores of full-term newborns.
Methods:
Cross-sectional study between October 2011 and July 2012 in which hematological parameters were evaluated for newborns in Viçosa, MG, Southeastern Brazil. It involved collecting 7 mL of umbilical cord blood from 144 full-term not underweight newborns. The parameters investigated were complete blood count, serum iron, ferritin and C-reactive protein. The time of umbilical cord clamping was measured using a digital timer without interfering in the procedures of childbirth. The birth data were collected from Live Birth Certificates and other information was obtained from the mother through a questionnaire applied in the first month postpartum. Analysis of multiple linear regression was then used to estimate the influence of biological, obstetrics and socioeconomic factors on the ferritin levels at birth.
Results:
The median ferritin was 130.3 µg/L (n = 129, minimum = 16.4; maximum = 420.5 µg/L), the mean serum iron was 137.9 μg/dL (n = 144, SD = 39.29) and mean hemoglobin was 14.7 g/dL (n = 144, SD = 1.47). The median time of cord clamping was 36 seconds, ranging between 7 and 100. The bivariate analysis detected an association between ferritin levels and color of the child, timing clamping of 60 seconds, type of delivery, the presence of gestational diabetes and per capita family income. In multivariate analysis, the variables per capita income, number of antenatal visits and length at birth accounted for 22.0% of variation in ferritin levels.
Conclusions:
Iron stores at birth were influenced by biological, obstetric and social characteristics. Tackling anemia should involve creating policies aimed at reducing social inequalities, improving the quality of antenatal care, as well as implementing a criterion of delayed clamping of the umbilical cord within the guidelines of labor.
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