Effects of Early and Delayed Cord Clamping on Haematocrit and Serum Bilirubin among Term Neonates at a Tertiary Hospital in North Central Nigeria

Abstract Background: The optimal timing for umbilical cord clamping, whether it is early cord clamping (ECC) immediately after birth or delayed cord clamping (DCC) done after a certain duration or cessation of cord pulsation, remains a topic of ongoing debate. The choice between these approaches has the potential to impact neonatal outcomes. Aim: The study aimed at comparing the effects of early versus delayed umbilical cord clamping on neonatal haematocrits and serum bilirubin after a normal delivery. Methods: This randomised controlled trial involved 178 term babies and mother pairs randomised into the DCC group (A) and ECC group (B). Neonatal haematocrit was measured at 2 and 24 h of life and serum bilirubin at 24 h of life. Other outcomes included neonatal anaemia, polycythaemia, jaundice and maternal post-partum blood loss. Results: The neonatal haematocrit was significantly higher in babies with delayed compared ECC at two hour ( P = 0.001) and 24 h after birth ( P = 0.001). The mean serum total bilirubin 24 h after birth was significantly higher in babies with DCC ( P = 0.001). The proportion of neonates with anaemia was not significantly different between the two groups ( P = 0.088), likewise the incidence of polycythaemia ( P = 0.146) and post-partum blood loss ( P = 0.097). Conclusion: The study’s findings underscore the benefits of DCC, as it increased neonatal haematocrit levels without leading to adverse maternal or neonatal outcomes and hence should be considered for adoption as a policy in our environment.