Effect of alternative positions of neonates prior to delayed cord clamping on placental transfusion: A randomized control trial

a Pediatrics , Hindu Rao Hospital , New Delhi , Delhi , India. b Neonatology , Maulana Azad Medical College , , New Delhi , Delhi , India. c Pediatrics , Hindu Rao Hospital , New Delhi , Delhi , India. d Pediatrics , Maulana Azad Medical College , ITO , New Delhi , Delhi , India.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 2018;:1-141.
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Abstract
OBJECTIVE To determine the effect of alternative positions (relative to placenta) of normal term neonates, prior to the recommended delayed cord clamping, on placental transfusion and short-term neonatal outcome. METHODS Normal term neonates born vaginally were randomly assigned to be placed either on mother's abdomen (Group AL, n = 97) or 20 cm below the introitus (Group BL, n = 102) for 90 seconds after delivery. Subsequently the cord was clamped. Outcome measures were anthropometry, hematological profile including ferritin at birth and at 3-4 months; and adverse effects, polycythemia and jaundice. RESULTS Both groups had comparable outcome measures at birth. At 3-4 months, mean hemoglobin (AL: 12.0 +/- 0.9 g/dl, BL: 12.3 +/- 1.1 g/dl; p = 0.02, 95% CI 0.03-0.58) and hematocrit (AL: 36.1 +/- 2.7%, BL: 37 +/- 3.2%; p = 0.01, 95% CI 0.1-1.75) were significantly higher in BL group. Anthropometry, serum ferritin, incidence of anemia and iron deficiency at 3-4 months were similar in both groups. There was no significant difference in polycythemia, jaundice requiring phototherapy or respiratory distress between the two groups. CONCLUSIONS Placing the baby below the placenta resulted in a statistically significant increase in hemoglobin and hematocrit at 3-4 months without any adverse outcomes. However, this meager quantum of increase did not translate into reduction of risk of anemia or improvement in iron stores. Registration number: CTRI/2013/06/003726.
Study details
Language : English
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine