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Implementation of Delayed Cord Clamping in Vigorous Preterm Neonates

Gabi Aliyev, Ana-Maria Gallo

    Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN
    |October 8, 2018
    PubMed

    Insights

    Delayed cord clamping (DCC) in vigorous preterm neonates significantly improved Apgar scores at 1 and 5 minutes. This evidence-based practice change enhanced obstetric team perspectives and is now standard clinical practice.

    Area of Science:

    • Neonatal Medicine
    • Evidence-Based Practice
    • Obstetrics

    Background:

    • Delayed cord clamping (DCC) offers benefits for preterm neonates, yet was not standard practice in this setting.
    • A need existed to implement evidence-based recommendations for DCC.

    Purpose of the Study:

    • To adopt and implement evidence-based recommendations for delayed cord clamping in vigorous preterm neonates.
    • To evaluate the impact of DCC on Apgar scores and obstetric team perspectives.

    Main Methods:

    • An evidence-based practice change project utilizing quantitative data.
    • An interprofessional obstetric team implemented DCC for up to 1 minute for vigorous preterm neonates (born before 37 weeks gestation).

    Main Results:

    • Apgar scores at 1 minute were significantly higher with DCC (M=8.35, SD=0.551) compared to immediate clamping (M=7.16, SD=1.834), p=.012.
    • Apgar scores at 5 minutes were significantly higher with DCC (M=9.00, SD=0.258) compared to immediate clamping (M=8.58, SD=0.838), p=0.046.

    Conclusions:

    • Delayed cord clamping was successfully adopted as a usual clinical practice for vigorous preterm neonates.
    • Implementation of DCC led to increased Apgar scores and improved obstetric team awareness, experience, and perspectives.
    Abstract

    Keywords:
    delayed cord clampingevidence-based practicequality improvementvigorous preterm neonates

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