Brief Delay in Cord Clamping and Neurobehaviour in Preterms

A Randomised Controlled Trial to Evaluate the Role of Brief Delay in Cord Clamping in Preterm Neonates (34-36weeks) on Short Term Neurodevelopmental Outcome

RESEARCH HYPOTHESIS Brief delay(>30 sec to <60 sec ) in cord clamping as compared to early cord clamping (< 20 sec) leads to a better short term neurobehavioural outcome in preterm (34-36 wks) neonates when assessed by neurobehavioral assessment of preterm infants (n.a.p.i.) at 37 weeks of post conceptional age

Delayed cord clamping (DCC) : Well described phenomenon in term infants .

• The optimal timing of clamping of umbilical cord in preterm infants : A subject of debate.
• Even a brief delay in cord clamping leads to an additional transfer of iron amounting to 40-50 mg/kg which may prevent iron deficiency.¹
• This low cost intervention can have significant public health importance in resource constrained settings.
• The effect of this intervention on neurobehaviour of preterm neonates has not been assessed.
• This aspect has been identified by WHO and Cochrane as a potentially researchable area

Inclusion Criteria:

• All preterm deliveries -infants born at 34 weeks 0 days to 36 weeks +6 days gestational age as estimated by last menstrual period or early ultrasound scan.
• Infants delivered vaginally or by caesarean section in cephalic presentation
• Singleton pregnancy
• Parental consent

Exclusion Criteria:

• Fetus with gross congenital anomaly
• Fetus with hydrops
• Rh negative pregnancy