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Published on: January 26, 2019
Factors Influencing Umbilical Cord Separation Time in Term and Preterm Newborns: A Prospective Cohort Study from a
Handan Ayhan Akoğlu1, Emine Tekin2
1Faculty of Medicine, Giresun University, Department of Pediatrics, Türkiye, Giresun.
Objective:
Umbilical cord separation time (UCST) may be influenced by neonatal, perinatal, maternal, and environmental factors. This study aimed to determine UCST in term and preterm newborns and to identify factors associated with its variation.
Study Design:
In this prospective cohort study, 970 newborns delivered between March 2021 and March 2022 at a tertiary maternity and children's hospital were enrolled. Demographic and perinatal data, maternal health history, and umbilical cord characteristics were recorded. Cord separation and related findings were assessed by parental interviews on postnatal days 7 and 14.
Results:
Of the 970 neonates, 51.7% were male, and 17.1% were preterm. Mean UCST was 8.5 ± 3.1 days (median: 8, range: 3-21). In univariable analyses, UCST was significantly longer in preterm infants (p = 0.028), after cesarean section (C/S; p < 0.001), and was shorter in summer than in autumn (p = 0.004). After revision of birth-weight categories in the categorical analysis, the association between birth-weight groups and UCST was no longer statistically significant (χ 2 = 6.43, p = 0.377). In multivariable linear regression performed in 902 newborns with complete data, higher lactate (β = -0.210, 95% CI: -0.413 to -0.006, p = 0.043) and hemoglobin (β = -0.166, 95% CI: -0.255 to -0.076, p < 0.001) levels were independently associated with shorter UCST, whereas C/S (β =1.171, 95% CI: 0.740-1.601, p < 0.001) and summer birth (β = -0.473, 95% CI: -0.893 to -0.053, p = 0.027) remained independently associated with UCST. The explanatory power of the model was limited (R 2 = 0.094).
Conclusion:
UCST was associated with several perinatal and environmental factors, although the observed effects were generally modest. In multivariable analysis, lactate, hemoglobin, delivery mode, and summer birth remained independently associated with UCST. Further multicenter studies are needed to clarify the mechanisms and clinical implications of these associations.
Key Points:
· Mean UCST was 8.5 days.. · UCST varied with perinatal factors.. · UCST differed across seasons.. · C/S was linked to longer UCST..
