WFRF:(Hellström Westas Lena 1954 )
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Elective caesarean : does delay in cord clamping for 30 s ensure sufficient iron stores at 4 months of age? A historical cohort control study
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- Andersson, Ola, 1965- (author)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Department of Research and Development, Region Halland, Sweden,Perinatal, neonatal och barnkardiologisk forskning/Hellström-Westas
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- Hellström-Westas, Lena, 1954- (author)
- Uppsala universitet,Pediatrik,Perinatal, neonatal och barnkardiologisk forskning/Hellström-Westas
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- Domellöf, Magnus (author)
- Umeå universitet,Pediatrik,Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
- (creator_code:org_t)
- 2016-11-02
- 2016
- English.
- In: BMJ Open. - : BMJ. - 2044-6055. ; 6:11
- Journal article (peer-reviewed)
Abstract
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- OBJECTIVE: To compare iron stores in infants born after elective caesarean section (CS) and a 30 s delay of umbilical cord clamping with those born vaginally after early (≤10 s) or delayed (≥180 s) cord clamping.DESIGN: Prospective observational study with historical control.SETTING: Swedish county hospital.POPULATION: 64 infants born after elective CS were compared with a historical control of 166 early clamped and 168 delayed clamped after vaginal birth.METHODS: Blood and iron status were measured in blood samples collected at birth, 48-96 hours after birth, 4 and 12 months of age.PRIMARY AND SECONDARY OUTCOME MEASURES: Ferritin at 4 months of age was the primary outcome, second outcome measures were other indicators of iron status, and haemoglobin, at 4 and 12 months of age, as well as respiratory distress at 1 and 6 hours after birth.RESULTS: At 4 months infants born by elective CS had better iron status than those born vaginally subjected to early cord clamping, shown by higher adjusted mean difference of ferritin concentration (39 µg/L (95% CI 10 to 60)) and mean cell volume (1.8 fL (95% CI 0.6 to 3.0)); and lower levels of transferrin receptors (-0.39 mg/L (95% CI -0.69 to -0.08)). No differences were seen between infants born after elective CS and delayed clamped vaginally born infants at 4 months. No differences were found between groups at 12 months of age.CONCLUSIONS: Waiting to clamp the umbilical cord for 30 s after elective CS results in higher iron stores at 4 months of age compared with early cord clamping after vaginal birth, and seems to ensure iron status comparable with those achieved after 180 s delayed cord clamping after vaginal birth.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
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