Factors associated with timing of umbilical cord clamping in tertiary hospital of Nepal.

Abstract

OBJECTIVE:

Delayed umbilical cord clamping (DCC) (≥ 60 s) is recognized to improve iron status and neurodevelopment compared to early umbilical cord clamping. The aim of this study is to identify current umbilical cord clamping practice and factors determining the timing of clamping in a low-resource setting where prevalence of anemia in infants is high.

RESULTS:

A cross-sectional study design including 128 observations of clinical practice in a tertiary-level maternity hospital in Kathmandu, Nepal. Overall 48% of infants received DCC. The mean and median cord clamping times were 61 ± 33 and 57 (38-79) s, respectively. Univariate analysis showed that infants born during the night shift were five times more likely to receive DCC (OR 5.6, 95% CI 1.4-38.0). Additionally, infants born after an obstetric complication were 2.5 times more likely to receive DCC (OR 2.5, 95% CI 1.2-5.3), and babies requiring ventilation had a 65% lower likelihood of receiving DCC (OR 0.35, 95% CI 0.13-0.88). Despite the existence of standard protocols for cord clamping and its proven benefit, the lack of uniformity in the timing of cord clamping reveals poor translation of clinical guidelines into clinical practice. Clinical trial registration ISRCTN97846009.

• Authors: Viktoria Nelin, Ashish Kc, Ola Andersson, Nisha Rana, Mats Målqvist
• Journal: BMC research notes (BMC Res Notes) Vol. 11 Issue 1 Pg. 89 (Jan 31 2018) ISSN: 1756-0500 [Electronic] England
• PMID: 29386046 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)

Chemical References

• Iron

Topics

• Anemia, Iron-Deficiency (prevention & control)
• Constriction
• Cross-Sectional Studies
• Delivery, Obstetric
• Female
• Humans
• Infant, Newborn
• Iron (blood)
• Live Birth
• Male
• Nepal
• Pregnancy
• Tertiary Care Centers
• Time Factors
• Umbilical Cord (surgery)