Evaluation of the effects of delayed cord clamping in neonates with intrauterine growth restriction

To assess the effects of delayed cord clamping (DCC) at birth on newborns diagnosed with intrauterine growth restriction (IUGR). This prospective, randomized, controlled study included newborns diagnosed with IUGR during pregnancy follow-up and born at a gestational age of ≥28 weeks. Early cord clamping (ECC) was performed immediately after birth, whereas DCC was performed 60 s postdelivery. The ECC and DCC groups were compared based on cord blood and 24-h venous hematocrit levels, polycythemia rates, and clinical complications associated with polycythemia. A total of 96 newborns, 48 in each group, were analyzed. Gestational weeks, birth weight, Apgar score, delivery mode, and maternal features were similar between the groups (P > .05). At 24 h postnatally, hematocrit values were significantly higher in the DCC group (61.27% ± 5.93%) compared to the ECC group (57.42% ± 7.10%) (P = .005). The 24-h polycythemia rate was also higher in the DCC group (31.3% vs. 12.5%, P = .02). Partial exchange transfusion (PET) was required for one neonate in the DCC group (2.1%). The rates of respiratory distress, phototherapy-requiring jaundice, hypoglycemia within the first two days, intensive care admission, and need for close monitoring were similar between the groups (P > .05). In neonates with IUGR, delayed cord clamping for 60 s at birth led to increased venous hematocrit levels and a higher polycythemia rate. Larger studies are warranted to clarify whether DCC influences the need for PET and the frequency or severity of polycythemia-associated clinical complications.