Delayed cord clamping in term large-for-gestational age infants: A prospective randomised study

Area of Science:

• Neonatal Medicine
• Obstetrics
• Pediatrics

Background:

• Large-for-gestational age (LGA) infants may experience unique post-natal challenges.
• Cord clamping timing is a critical factor in neonatal transition.
• Early cord clamping (ECC) and delayed cord clamping (DCC) have differing physiological impacts.

Purpose of the Study:

• To compare post-natal outcomes of delayed cord clamping (DCC) versus early cord clamping (ECC).
• To assess the effects of DCC and ECC in term large-for-gestational age (LGA) infants.

Main Methods:

• Prospective randomized study of 51 term LGA infants.
• Infants randomized to ECC (clamped at 15 seconds) or DCC (clamped at 60 seconds).
• Key outcomes included Apgar scores, cord blood gases, hematocrit, bilirubin levels, hospital stay, and NICU admissions.

Main Results:

• No significant differences in post-natal hematocrit or bilirubin levels between ECC and DCC groups.
• Polycythemia and hyperbilirubinemia rates were similar; no treatment was required for polycythemia.
• Three neonates in the DCC group required NICU admission for transient tachypnea.

Conclusions:

• Delayed cord clamping (DCC) did not significantly increase post-natal complications in term LGA infants in this study.
• Larger studies with long-term follow-up are necessary to fully evaluate the risks and benefits of DCC in this population.