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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
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Department of Research and Development, Region Halland, Sweden. (Perinatal, neonatal och barnkardiologisk forskning/Hellström-Westas)ORCID-id: 0000-0002-3972-0457
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik. (Perinatal, neonatal och barnkardiologisk forskning/Hellström-Westas)
Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
2016 (Engelska)Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, nr 11, artikel-id e012995Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

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.

Ort, förlag, år, upplaga, sidor
2016. Vol. 6, nr 11, artikel-id e012995
Nationell ämneskategori
Reproduktionsmedicin och gynekologi Pediatrik
Identifikatorer
URN: urn:nbn:se:uu:diva-308092DOI: 10.1136/bmjopen-2016-012995ISI: 000391303400007PubMedID: 27807089OAI: oai:DiVA.org:uu-308092DiVA, id: diva2:1049182
Tillgänglig från: 2016-11-23 Skapad: 2016-11-23 Senast uppdaterad: 2017-11-29Bibliografiskt granskad

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