Koppad Bhavana, Rajkumar Charkala, Nyamagoudar Anita, Hukkeri Manjunath, Meghana Kanchibhotla, Bellad Mrutyunjaya B
Department of Paediatrics, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (KAHER), Belagavi, Karnataka, 590010, India.
Department of Neonatology, SDM College of Medical Sciences and Hospital, a Unit of SDM University, Dharwad, Karnataka, 580009, India.
Eur J Pediatr. 2025 May 21;184(6):353. doi: 10.1007/s00431-025-06166-w.
The objective of the study was to compare the serum ferritin levels (by chemiluminescence immunoassay) among two groups of newborns with intact umbilical cord milking (UCM) versus delayed cord clamping (DCC) at the 3rd month of life. Randomized controlled trial, unblinded, parallel group was conducted at tertiary care referral unit in South India after obtaining informed consent from eligible mothers in late preterm gestation and beyond, and the newborn babies were randomized into two groups by computer-generated sequence (SNOSE method) with two modes of umbilical cord management UCM and DCC. A total of 190 mothers were enrolled, and they were randomized into two arms: DCC group (n = 95) and UCM group (n = 95). Of these 190 mothers who were enrolled, the intervention was done for 180 babies, i.e., DCC (n = 92) and UCM (n = 88). Follow-up with serum ferritin was done for 108 babies. DCC-63 and UCM-45. Ferritin levels measured at 3 months of life showed comparable results, i.e., mean ferritin levels in the DCC group was 258.07 ng/ml and in the UCM group was 248.44 ng/ml, with a mean difference of - 9.63 (p 0.72).
Both UCM and DCC resulted in comparable levels of serum ferritin at 3 months of life, implying that a similar amount of placental transfusion occurs in both the groups. UCM is a feasible alternative to prevent anemia during infancy as compared to DCC when the latter cannot be done due to undue limitation.
CTRI registration number: CTRI/2021/05/033448. (07/05/2021).
• DCC is the standard of care for stable term and preterm babies at birth. However, UCM is a reasonable alternative for cord management at birth.
• UCM prevents anemia as effectively as DCC, as evidenced by comparable serum ferritin levels at 3 months of age, further adding to the hypothesis that UCM is a feasible alternative when DCC is not practical.
本研究的目的是比较两组新生儿在出生后3个月时的血清铁蛋白水平(通过化学发光免疫分析法测定),一组采用脐带挤血(UCM),另一组采用延迟脐带结扎(DCC)。在印度南部的三级医疗转诊单位进行了一项非盲、平行组随机对照试验,纳入了妊娠晚期早产及更晚期的符合条件的母亲并获得其知情同意,新生儿通过计算机生成的序列(SNOSE方法)随机分为两组,采用两种脐带处理方式,即UCM和DCC。共纳入190名母亲,她们被随机分为两组:DCC组(n = 95)和UCM组(n = 95)。在这190名纳入的母亲中,对180名婴儿进行了干预,即DCC组(n = 92)和UCM组(n = 88)。对108名婴儿进行了血清铁蛋白随访,DCC组63名,UCM组45名。出生后3个月时测得的铁蛋白水平显示出可比的结果,即DCC组的平均铁蛋白水平为258.07 ng/ml,UCM组为248.44 ng/ml,平均差异为 -9.63(p = 0.72)。
UCM和DCC在出生后3个月时导致的血清铁蛋白水平相当,这意味着两组中发生的胎盘输血量相似。当由于不适当的限制无法进行DCC时,与DCC相比,UCM是预防婴儿期贫血的一种可行替代方法。
CTRI注册号:CTRI/2021/05/033448。(2021年5月7日)。
• DCC是足月和早产稳定婴儿出生时的标准护理方法。然而,UCM是出生时脐带处理的一种合理替代方法。
• UCM预防贫血的效果与DCC一样有效,3个月龄时血清铁蛋白水平相当证明了这一点,这进一步支持了以下假设:当DCC不可行时,UCM是一种可行的替代方法。