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| babycenter.com |
November 17
is celebrated as World Prematurity Day
and theme for this year is ‘let them thrive.’
According to
WHO An estimated 15 million babies are born preterm every year – more than 1 in
10 babies around the world and this number is rising. Preterm birth
complications are the leading cause of death for children under 5.
Well, the
obstetricians and health care personal assisting in child birth could save
thousands of lives by waiting 60 seconds before clamping the umbilical
cord after birth instead of clamping it immediately reports the results of a systematic
review and meta-analysis led by the University of Sydney's National Health and
Medical Research Council Clinical Trials Centre.
The review will
be published in forthcoming issue of American Journal of Obstetrics and
Gynecology.
The
researchers looked into data from 18 randomized controlled trials that compared
delayed vs early clamping amounting to total of 2834 infants born before 37
weeks' gestation. The cord was clamped after 60 seconds in infants allocated to
delayed cord clamping group.
Infants who
had their cord clamped after 1 minute faced a 32% reduced risk of mortality and
33 infants need to have delayed cord clamping to save one infant (number need
to treat = 33).
Out of 18
trials, 3 trials consisted of about 1000 infants born before ≤28 weeks’
gestation. They had a 30% reduction in mortality and the number need to treat
was 20.
The two
groups were comparable for Apgar scores, intubation for resuscitation,
admission temperature, mechanical ventilation, intraventricular hemorrhage,
brain injury, chronic lung disease, patent ductus arteriosus, necrotizing
enterocolitis, late-onset sepsis, or retinopathy of prematurity.
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| combatbootmama.com |
Delay in
cord clamping improved the hematocrit by 3% and 10% fewer babies required blood
transfusion.
The side
effects of delayed clamping were polycythemia and hyperbilirubinemia.
"The
review shows for the first time that simply clamping the cord 60 seconds after
birth improves survival," said the University of Sydney's Professor
William Tarnow-Mordi, senior author.
"It
confirms international guidelines recommending delayed clamping in all preterm
babies who do not need immediate resuscitation."
"We
estimate that for every thousand very preterm babies born more than ten weeks
early, delayed clamping will save up to 100 additional lives compared with
immediate clamping," said the University of Sydney's Associate Professor
David Osborn, the review's lead author and a neonatal specialist at Royal
Prince Alfred Hospital.
"This
means that, worldwide, using delayed clamping instead of immediate clamping can
be expected to save between 11,000 and 100,000 additional lives every
year."
The study findings
are in accordance with a second Australian study published in The New
England Journal of Medicine. The
Australian study enrolled about 1500 babies, from25 centers in 7 countries. The
babies were born on an average 10 weeks early. Delayed cord clamping saved 3% more
babies, as compared to immediate cord clamping (mortality was 6% vs 9%)(p=0.03).
Currently,
WHO recommends waiting at least 60 seconds before cord clamping in premature
and term babies.
ACOG also
recommends, “a delay in umbilical cord clamping for all healthy infants for at
least 30-60 seconds after birth given the numerous benefits to most newborns.”
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