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Wait a minute?: An observational cohort study comparing iron stores in healthy Swedish infants at 4 months of age after 10-, 60- and 180-second umbilical cord clamping
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2017 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 7, no 12, article id e017215Article in journal (Refereed) Published
Abstract [en]

Background and objective: Umbilical cord blood (UCB) is a valuable stem cell source used for transplantation. Immediate umbilical cord (UC) clamping is widely practised, but delayed UC clamping is increasingly advocated to reduce possible infant anaemia. The aim of this study was to investigate an intermediate UC clamping time point and to evaluate iron status at the age of 4 months in infants who had the UC clamped after 60 s and compare the results with immediate and late UC clamping. Design: Prospective observational study with two historical controls. Setting: A university hospital in Stockholm, Sweden, and a county hospital in Halland, Sweden. Methods: Iron status was assessed at 4 months in 200 prospectively recruited term infants whose UC was clamped 60 s after birth. The newborn baby was held below the uterine level for the first 30 s before placing the infant on the mother's abdomen for additional 30 s. The results were compared with data from a previously conducted randomised controlled trial including infants subjected to UC clamping at ≤10 s (n=200) or ≥180 s (n=200) after delivery. Results: After adjustment for age differences at the time of follow-up, serum ferritin concentrations were 77, 103 and 114 μg/L in the 10, 60 and 180 s groups, respectively. The adjusted ferritin concentration was significantly higher in the 60 s group compared with the 10 s group (P=0.002), while the difference between the 60 and 180 s groups was not significant (P=0.29). Conclusion: In this study of healthy term infants, 60 s UC clamping with 30 s lowering of the baby below the uterine level resulted in higher serum ferritin concentrations at 4 months compared with 10 s UC clamping. The results suggest that delaying the UC clamping for 60 s reduces the risk for iron deficiency. © 2017 Article author(s).

Place, publisher, year, edition, pages
BMJ Publishing Group , 2017. Vol. 7, no 12, article id e017215
Keywords [en]
fetal medicine, iron deficiency, paediatrics, umbilical cord clamping, ferritin, hemoglobin, iron, adult, anemia, Article, birth weight, blood cell count, body mass, cohort analysis, controlled study, female, ferritin blood level, follow up, gestational age, head circumference, human, iron storage, major clinical study, newborn, observational study, obstetric procedure, prospective study, randomized controlled trial, sex difference, Sweden, university hospital, vacuum extraction, vaginal delivery, birth, blood, child health, comparative study, deficiency, fetus blood, infant, iron deficiency anemia, ligation, male, metabolism, obstetric delivery, pregnancy, puerperium, stem cell, time factor, transplantation, umbilical cord, vascularization, Anemia, Iron-Deficiency, Constriction, Delivery, Obstetric, Ferritins, Fetal Blood, Humans, Infant Health, Infant, Newborn, Parturition, Postpartum Period, Prospective Studies, Stem Cells, Time Factors, Tissue and Organ Harvesting
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:du-38869DOI: 10.1136/bmjopen-2017-017215Scopus ID: 2-s2.0-85051948984OAI: oai:DiVA.org:du-38869DiVA, id: diva2:1615639
Available from: 2021-11-30 Created: 2021-11-30 Last updated: 2023-08-28Bibliographically approved

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Wiklund, Ingela

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