Hemodynamic parameters after Delayed Cord Clamping (DCC) in term neonates: a prospective observational study

Area of Science:

• Neonatal physiology
• Cardiovascular dynamics
• Perinatal medicine

Background:

• Delayed cord clamping (DCC) is a global standard practice for term and preterm infants.
• Understanding the hemodynamic impact of DCC on transitional circulation is crucial.

Purpose of the Study:

• To investigate the hemodynamic effects of DCC on transitional circulation in term neonates.
• To evaluate cardiac output parameters and heart rate changes following DCC.

Main Methods:

• Prospective observational study in a tertiary care hospital.
• Functional echocardiography used to measure right ventricular output (RVO), left ventricular output (LVO), superior vena cava (SVC) flow, and heart rate (HR) at 12 and 48 hours of life.
• Included term neonates, with analysis of small for gestational age (SGA) and appropriate for gestational age (AGA) subgroups.

Main Results:

• DCC resulted in less fluctuation in hemodynamic parameters (HR, cardiac output) between 12 and 48 hours.
• SGA neonates demonstrated significantly higher baseline HR, LVO, RVO, and SVC flow compared to AGA neonates.
• LVO in SGA neonates post-DCC was notably lower than reported in other studies, suggesting a cardio-stabilizing effect.

Conclusions:

• Delayed cord clamping contributes to hemodynamic stability in term neonates.
• SGA infants exhibit distinct hemodynamic profiles and benefit from DCC, with evidence of cardio-stabilization.
• Further research is warranted to establish normative hemodynamic data for SGA neonates undergoing DCC.