The time and duration of umbilical cord clamping in babies born in the public hospitals of Khorasan Razavi during 2020 to 2022

Document Type : Original Article

Authors

1 Associate professor, Department of Midwifery, School of Medical Sciences, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.

2 B.Sc. of Midwifery, Kashmar Hazrat Abolfazl Hospital, Mashhad University of Medical Sciences, Kashmar, Iran.

3 B.Sc. of Midwifery, Khaf 22 Bahman Hospital, Mashhad University of Medical Sciences, Khaf, Iran.

4 B.Sc. of Midwifery, Sarkhs Loqman Hakim Hospital, Mashhad University of Medical Sciences, Sarkhs, Iran.

5 B.Sc. of Midwifery, Mashhad Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Student of Psychology, Khayyam University, Mashhad, Iran.

7 Resident Fellowship of Neonatology, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

8 Professor, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

10.22038/ijogi.2024.67424.5433

Abstract

Introduction: The time of umbilical cord clamping is an important strategy for better prognosis of preterm and full-term infants, and all health care providers should be informed about the components and importance of this approach. The present study was performed with aim to investigate the time and duration of umbilical cord clamping in the delivery or operating room of Khorasan Razavi Hospitals.
Methods: This descriptive study was conducted on 1237 babies born in the delivery or operating room of Khorasan Razavi public Hospitals between 2020 and 2022 with available sampling. In each hospital, a researcher assistant midwife who was not involved in the delivery process recorded the time of umbilical cord clamping after birth, and in the next step, she recorded the possible cause of early umbilical cord clamping by asking the obstetrician. Data were analyzed by SPSS software (version 26) and descriptive statistics tests. P<0.05 was considered statistically significant.
Results: In this study, 165 neonates (13.4%) were premature and 1072 neonates (86.6%) were born full term. In addition, 915 neonates (73.96%) were born naturally and other 322 neonates (26.04%) by cesarean section. The mean duration of the umbilical cord clamping of the newborns was 35.25 ± 27.29 second, which was reported as 21.29 ± 14.95 second in cesarean section and 40.22 ± 28.92 second in natural delivery. In 719 neonates (58.1%), the umbilical cord is closed before 30 seconds and in 322 neonates (26%) before 15 seconds. Among the causes of early umbilical cord clamping, hasting by obstetrician (30%), caesarean section (3.7%), doctor's routine (2.1%) and mother's non-cooperation (1.5%) were the most common causes.
Conclusion: Umbilical cord clamping is done quickly or very quickly in the delivery room of Khorasan Razavi public hospitals, and in caesarean section, this urgency is very noticeable, and the most common cause of hasting is obstetrician. Therefore, correcting the thinking of the obstetrician in order to improve the time of umbilical cord clamping seems necessary. Delaying umbilical cord clamping plays an important role in the transition from fetal to newborn blood circulation and improves the health of newborns.

Keywords

Main Subjects

References

  1. Aneja S. Integrated management of newborn and childhood illness (IMNCI) strategy and its implementation in real life situation. The Indian Journal of Pediatrics 2019; 86(7):622-7.
  2. Bryce E, Mullany LC, Khatry SK, Tielsch JM, LeClerq SC, Katz J. Coverage of the WHO’s four essential elements of newborn care and their association with neonatal survival in southern Nepal. BMC pregnancy and childbirth 2020; 20:1-9.
  3. Marshall S, Lang AM, Perez M, Saugstad OD. Delivery room handling of the newborn. Journal of perinatal medicine 2019; 48(1):1-10.
  4. Hutchon DJ. Why do obstetricians and midwives still rush to clamp the cord?. BMJ 2010; 341.
  5. Leduc D, Senikas V, Lalonde AB, Ballerman C, Biringer A, Delaney M, et al. Active management of the third stage of labour: prevention and treatment of postpartum hemorrhage. Journal of obstetrics and gynaecology Canada 2009; 31(10):980-93.
  6. McDonald SJ, Middleton P, Dowswell T, Morris PS. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Evidence‐Based Child Health: A Cochrane Review Journal 2014; 9(2):303-97.
  7. Chen X, Li X, Chang Y, Li W, Cui H. Effect and safety of timing of cord clamping on neonatal hematocrit values and clinical outcomes in term infants: a randomized controlled trial. Journal of Perinatology 2018; 38(3):251-7.
  8. Katheria AC, Lakshminrusimha S, Rabe H, McAdams R, Mercer JS. Placental transfusion: a review. Journal of Perinatology 2017; 37(2):105-11.
  9. Mercer JS, Erickson-Owens DA, Collins J, Barcelos MO, Parker AB, Padbury JF. Effects of delayed cord clamping on residual placental blood volume, hemoglobin and bilirubin levels in term infants: a randomized controlled trial. Journal of Perinatology 2017; 37(3):260-4.
  10. Soraisham AS, Srivastava A. Recent update on neonatal resuscitation. Indian Journal of Pediatrics 2022; 89(3):279-87.
  11. Jelin AC, Kuppermann M, Erickson K, Clyman R, Schulkin J. Obstetricians’ attitudes and beliefs regarding umbilical cord clamping. The Journal of Maternal-Fetal & Neonatal Medicine 2014; 27(14):1457-61.
  12. World Health Organization. Guideline: delayed umbilical cord clamping for improved maternal and infant health and nutrition outcomes. World Health Organization; 2014.
  13. Qian Y, Ying X, Wang P, Lu Z, Hua Y. Early versus delayed umbilical cord clamping on maternal and neonatal outcomes. Archives of gynecology and obstetrics 2019; 300:531-43.
  14. Stoll K, Hutton E. A survey of umbilical cord clamping practices and attitudes of Canadian maternity care providers. Can J Midwifery Res Pract 2012; 11(3):18-20.
  15. Janngiab C, Suthutvoravut S. The Timing of Umbilical Cord Clamping and Its Effect on Maternal and Neonatal Outcomes in a Private Hospital, Bangkok, Thailand. Ramathibodi Medical Journal 2020; 43(3):8-14.
  16. Isacson M, Thies-Lagergren L, Oras P, Hellström-Westas L, Andersson O. Umbilical cord clamping and management of the third stage of labor: A telephone-survey describing Swedish midwives’ clinical practice. European Journal of Midwifery 2022; 6.
  17. Winkler A, Isacson M, Gustafsson A, Svedenkrans J, Andersson O. Cord clamping beyond 3 minutes: Neonatal short‐term outcomes and maternal postpartum hemorrhage. Birth 2022; 49(4):783-91.
  18. Farrar D, Airey R, Law GR, Tuffnell D, Cattle B, Duley L. Measuring placental transfusion for term births: weighing babies with cord intact. BJOG: An International Journal of Obstetrics & Gynaecology 2011; 118(1):70-5.
  19. Eichenbaum-Pikser G, Zasloff JS. Delayed clamping of the umbilical cord: a review with implications for practice. Journal of midwifery & women's health 2009; 54(4):321-6.
  20. McDonald SJ, Middleton P, Dowswell T, Morris PS. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Evidence‐Based Child Health: A Cochrane Review Journal 2014; 9(2):303-97.
  21. World Health Organization. Essential newborn care course. World Health Organization; 2010.
  22. Al-Salam Z, Al-Alaiyan S, Alallah J, Al-Hazzani F, Alfaleh K, Alsaedi S, et al. The golden hour approach: practical guidelines of the Saudi neonatology society on managing very low birth weight infants in the first hour of life. Journal of Clinical Neonatology 2016; 5(4):222-9.
  23. Andersson O, Lindquist B, Lindgren M, Stjernqvist K, Domellöf M, Hellström-Westas L. Effect of delayed cord clamping on neurodevelopment at 4 years of age: a randomized clinical trial. JAMA pediatrics 2015; 169(7):631-8.
  24. Boere I, Smit M, Roest AA, Lopriore E, van Lith JM, te Pas AB. Current practice of cord clamping in the Netherlands: a questionnaire study. Neonatology 2014; 107(1):50-5.
  25. Rabe H, Mercer J, Erickson-Owens D. What does the evidence tell us? Revisiting optimal cord management at the time of birth. European Journal of Pediatrics 2022; 181(5):1797-807.
  26. Nelin V, Kc A, Andersson O, Rana N, Målqvist M. Factors associated with timing of umbilical cord clamping in tertiary hospital of Nepal. BMC Research Notes 2018; 11:1-6.
  27. Herold J, Abele H, Graf J. Effects of timing of umbilical cord clamping for mother and newborn: a narrative review. Archives of Gynecology and Obstetrics 2023: 1-6.
  28. Mercer JS, Nelson CC, Skovgaard RL, Chern-Hughes B. Umbilical cord clamping: beliefs and practices of American nurse-midwives. Journal of Midwifery & Women's Health 2000; 45(1):58-66.
  29. Aladangady N, McHugh S, Aitchison TC, Wardrop CA, Holland BM. Infants' blood volume in a controlled trial of placental transfusion at preterm delivery. Pediatrics 2006; 117(1):93-8.
  30. Fawzy AE, Moustafa AA, El-Kassar YS, Swelem MS, El-Agwany AS, Diab DA. Early versus delayed cord clamping of term births in Shatby Maternity University Hospital. Progresos de Obstetricia y Ginecología 2015; 58(9):389-92.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 26, Issue 11
January 2024
Pages 13-22

Files

Share

How to cite

Statistics