Comparison of the Effect of Early and Late Umbilical Cord Clamping on the Apgar score of the Neonate

Document Type : Original Article


1 Midwife, Instructor, Gorgan Islamic Azad University, Gorgan, Iran

2 Midwife, instructor, Nursing and Midwifery School, Mashhad University of Medical Sciences, Mashhad, Iran

3 Ph.D. in Nursing, Nursing and Midwife School, Mashhad, Iran


Introduction: After decades of discussion and dialogue, there is little agreement about suitable time for after birth umbilical cord clamping. By using the late cord clamping, neonate receives more placental transfusion that may affect the Apgar score. This study was designed to compare the effect of early and late cord clamping on the Apgar score of the neonate.
Methods and Materials: This double blind, randomized, clinical trial carried out, in the year 2002 at Deziani Hospital of Gorgan, Iran. This study was approved by the local committee of medical ethics. Healthy full-term vaginally born neonates (n=64), were randomly allocated to early (30s) and late (3min) umbilical cord clamping group. During this period of time, the attendant held the neonate supine at the level of introitus. At the end of 1min and 5mins after birth The Apgar score of the neonate, residual placental blood volume and estimated neonatal blood volume were determined. Data obtained by interview and observation, analyzed by SPSS software, Mann Whitney, t student and Chi-squared tests.
Results: There was a significant difference between early and late umbilical cord clamping groups (p<0.001), in the 1min and 5mins Apgar scores of the neonate. Placental residual blood volume in the late cord clamping group was 39.5% lower than the early cord clamping group (p<0.001). Estimated neonatal blood volume in late cord clamping group was 7.1% higher than early cord clamping group (p<0.001).
Conclusion: Late cord clamping leads to a significant increase in the Apgar score of the neonate and the estimated neonatal blood volume. However, the placental residual blood volume significantly decreased. Further trials should delay cord clamping until cessation of cord pulse or alter the level that the newborn is kept.


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