American Journal of Clinical Nutrition, Vol 65, 425-431, Copyright © 1997 by The American Society for Clinical Nutrition, Inc

ORIGINAL RESEARCH COMMUNICATIONS

Delayed clamping of the umbilical cord improves hematologic status of Guatemalan infants at 2 mo of age

R Grajeda, R Perez-Escamilla and KG Dewey
Instituto de Nutricion de Centro America y Panama (INCAP), Guatemala City, Guatemala.

Iron deficiency anemia is a serious health problem that affects the physical and cognitive development of children. Therefore, it is important to develop cost-effective interventions to improve the hematologic status of the millions of children affected by this condition worldwide. We studied 69 Guatemalan infants who had been randomly assigned to one of three groups at the time of delivery: 1) cord clamping immediately after delivery (n = 21); 2) clamping when the cord stopped pulsating, with the infant placed at the level of the placenta (n = 26); or 3) clamping when the cord stopped pulsating, with the newborn placed below the level of the placenta (n = 22). Maternal and infant hematologic assessments were performed at the time of delivery and 2 mo postpartum. At baseline the groups had similar socioeconomic, demographic, and biomedical characteristics and the newborns had similar hematocrit status. Two months after delivery, infants in the two groups with delayed cord clamping had significantly higher hematocrit values and hemoglobin concentrations than did those in the early-clamping group. The percentage with hematocrit values < 0.33 was 88% in the control group compared with 42% in group 2 and 55% in group 3 (P = 0.01). These results suggest that waiting until the umbilical cord stops pulsating (approximately 1 min after delivery) is a feasible low-cost intervention that can reduce anemia in infants in developing countries.

This article has been cited by other articles:

				C A Ultee, J van der Deure, J Swart, C Lasham, and A L van Baar Delayed cord clamping in preterm infants delivered at 34 36 weeks' gestation: a randomised controlled trial Arch. Dis. Child. Fetal Neonatal Ed., January 1, 2008; 93(1): F20 - F23. [Abstract] [Full Text] [PDF]

				E. K. Hutton and E. S. Hassan Late vs Early Clamping of the Umbilical Cord in Full-term Neonates: Systematic Review and Meta-analysis of Controlled Trials JAMA, March 21, 2007; 297(11): 1241 - 1252. [Abstract] [Full Text] [PDF]

				P. F van Rheenen and B. J Brabin A practical approach to timing cord clamping in resource poor settings BMJ, November 4, 2006; 333(7575): 954 - 958. [Full Text] [PDF]

				J. M. Ceriani Cernadas, G. Carroli, L. Pellegrini, L. Otano, M. Ferreira, C. Ricci, O. Casas, D. Giordano, and J. Lardizabal The Effect of Timing of Cord Clamping on Neonatal Venous Hematocrit Values and Clinical Outcome at Term: A Randomized, Controlled Trial Pediatrics, April 1, 2006; 117(4): e779 - e786. [Abstract] [Full Text] [PDF]

				M. S Golub, C. E Hogrefe, A. F Tarantal, S. L Germann, J. L Beard, M. K Georgieff, A. Calatroni, and B. Lozoff Diet-induced iron deficiency anemia and pregnancy outcome in rhesus monkeys Am. J. Clinical Nutrition, March 1, 2006; 83(3): 647 - 656. [Abstract] [Full Text] [PDF]

				Z. A. Bhutta, G. L. Darmstadt, B. S. Hasan, and R. A. Haws Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence Pediatrics, February 1, 2005; 115(2/S1): 519 - 617. [Abstract] [Full Text] [PDF]

				M. F. Miller, R. J. Stoltzfus, N. V. Mbuya, L. C. Malaba, P. J. Iliff, J. H. Humphrey, and the ZVITAMBO Study Group Total Body Iron in HIV-Positive and HIV-Negative Zimbabwean Newborns Strongly Predicts Anemia throughout Infancy and Is Predicted by Maternal Hemoglobin Concentration J. Nutr., November 1, 2003; 133(11): 3461 - 3468. [Abstract] [Full Text] [PDF]