Effect of Delayed Cord Clamping on Respiratory Infection-Related Encounters in the First 6 Months of Life in an Urban Community Hospital
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Ronique Gordon1, Neelam Neupane1, Leidi Pedraza Gonzalez1
1Department of Pediatrics, Flushing Hospital Medical Center, Flushing, New York, USA, flushinghospital.org.
Insights
Delayed umbilical cord clamping (DCC) in newborns reduces hyperbilirubinemia and respiratory infections. This practice, involving a 30-60 second delay, enhances neonatal immunity by increasing blood volume, leading to fewer emergency visits and hospitalizations in the first six months.
Area of Science:
- Neonatal Medicine
- Pediatric Health
- Immunology
Background:
- Delayed umbilical cord clamping (DCC) for 30-60 seconds is recommended for term and preterm infants.
- Increased neonatal blood volume from DCC is rich in stem cells and immunoglobulins, potentially offering protection against infections.
Purpose of the Study:
- To compare the effects of DCC in term newborns on hyperbilirubinemia and respiratory infection-related pediatric emergency department (PED) encounters and hospitalizations within the first six months of life.
Main Methods:
- A retrospective chart review of term infants born between January 1, 2022, and December 31, 2022.
- Infants were grouped into DCC (30-60 seconds) and non-delayed umbilical cord clamping (nDCC) groups.
- Comparison of maternal/newborn characteristics, hyperbilirubinemia, respiratory infection-related PED encounters, hospitalizations, and length of stay.
Main Results:
- Fewer respiratory infection-related PED encounters (p < 0.001) and hospitalizations (p = 0.04) were observed in the DCC group.
- A statistically significant 5% lower incidence of hyperbilirubinemia was found in the DCC group (p = 0.02).
- No significant difference in hospitalization length of stay between the groups (p = 0.07).
Conclusions:
- Delayed umbilical cord clamping (DCC) is associated with reduced hyperbilirubinemia and fewer respiratory infection-related PED encounters and hospitalizations in the first six months of life.
- The enhanced blood volume and its components from DCC appear to support the neonate's immune system, reducing disease burden.
- DCC is a beneficial practice for improving neonatal health outcomes.
Background/Objective:
Delayed umbilical cord clamping (DCC) for 30-60 s after birth is recommended for both term and preterm infants. The additional neonatal blood volume rich in stem cells and immunoglobulins may protect the neonate from infections. We aim to compare the effect of DCC in term newborns on hyperbilirubinemia and respiratory infection-related pediatric emergency department (PED) encounters and hospitalizations within the first 6 months of life.
Methods:
We conducted a chart review of term infants born between January 1, 2022 and December 31, 2022 and grouped them as either having DCC or not having delayed umbilical cord clamping (nDCC) for 30-60 s after birth. Maternal and newborn characteristics, hyperbilirubinemia, respiratory infection-related PED encounters, hospitalizations, and length of stay in the initial 6 months after birth were compared. Data were analyzed using R software, a p value of < 0.05 was considered statistically significant.
Results:
Of the 2136 charts reviewed, 659 (31%) were in the DCC group. There were significantly fewer respiratory infection-related PED encounters (p < 0.001), fewer hospitalizations (p = 0.04), and a 5% lower incidence of hyperbilirubinemia in the DCC group (95% CI: 0.86%-8.6%; p = 0.02). The length of stay of each hospitalization was not significantly different between the two groups, p = 0.07.
Conclusions:
We observed fewer respiratory infection-related PED encounters and hospitalizations in the initial 6 months of life and a lower incidence of hyperbilirubinemia among the infants who had DCC. The increased blood volume and its components appear to be supportive of the neonate's developing immune system as seen in the lower disease burden up to 6 months of age.
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