Effect of Umbilical Cord Milking on Iron Related Health Outcomes for Cesarean-Delivered Infants

Effect of Umbilical Cord Milking on Iron Related Health Outcomes for Cesarean-Delivered Infants: A Randomized Controlled Trial

This study aims to determine whether umbilical cord milking can improve iron related health outcomes for cesarean-delivered infants. Half of participants will receive umbilical cord milking, while the other half will receive routine clinical treatment and care.

In recent years, several professional organizations have recommended delayed cord clamping to improve placental transfusion for newborns born vaginally based on a series of randomized controlled studies. However, no similar recommendations are available for cesarean-delivered infants. Investigators found that cesarean-delivered infants were more vulnerable to iron deficiency and anemia compared with those born vaginally, suggesting that it is urgently needed to find a similar anemia prevention strategy for infants born by cesarean sections.

In this study, investigators aim to test whether umbilical cord milking (UCM), a potentially promising strategy for cesarean delivery, can improve iron related health outcomes for cesarean-delivered infants. A total of 450 term pregnant women who are planning to give births by cesarean sections will be enrolled from two hospitals in Hunan province and randomly assigned to either UCM group or control group. Infants will be followed up at 1, 6, 12, 18 months for the evaluation of the impact of UCM on iron deficiency, anemia, as well as growth and the developmental status of language and mental/behavioral outcomes.

Inclusion Criteria:

• Singleton pregnancy
• Full-term pregnancy (no less than 37 gestational weeks)
• Cesarean section before the labor starts or cesarean section after the labor starts but with cervix less than 3 cm
• Plan to take vaccines and receive routine child health care in the hospital where she gives birth

Exclusion Criteria:

• Maternal hypertensive disorder
• Gestational diabetes with macrosomia
• Gestational diabetes with polyhydramnios
• Maternal severe anemia with hemoglobin less than 70 g/L
• Maternal coagulation disorders
• Fetal growth restriction
• Major congenital anomalies
• Hemolytic disease of the newborn or hydrops fetalis
• Short umbilical cord length (< 30 cm)
• Severe cord or placenta abnormalities such as cord prolapse, true knots, placental abruption and placenta previa
• Other conditions that are not suitable for the study judged by the doctors