Neonatal Outcomes In Cord Clamping And Its Association With Hematological Parameters

Abstract

Objective: To compare the neonatal outcomes in early and delayed cord clamping and to find Its association with hematological parameters in neonates of Jinnah Postgraduate Medical Centre, Karachi. Study Design and Setting: It was a cross sectional study conducted from 1st July 2016 to 31st December 2016 at Department of Obstetrics & Gynaecology, Jinnah Postgraduate Medical Centre, Karachi. Methodology: 342 pregnant women were selected through convenient sampling technique meeting inclusion criteria after obtaining ethical approval all pimigravida with age range of 25 to 45 years with singleton term pregnancy delivered through normal vaginal delivery, in 3rd stages of labour were included in the study. Multi-gravid women or any women with a Systemic disease such as hypertension, diabetes mellitus thyroid disorder, and cardiac disease were excluded. Demographic variables, blood parameters, were recorded. SPSS version 20.0 was used for data analysis. Neonatal outcomes were assessed in terms of neonatal haemoglobin, haematocrit, platelet count and bilirubin level with respect to early and delayed cord clamping. Descriptive statistics were calculated. P-value = 0.05 was taken as significant. Results: the total of 342 pregnant women selected for this study, divided into 2 groups depending upon early (gp-1) or late clamping(gp-2). The mean haemoglobin in group 1 was 13.2 mg/dl and in group 2 was 13.4 mg/dl. Mean haematocrit in group 1 was 40.8 % and in group 2 were 41.3 %. (P-value=0.03). Polycythemia in group 1 was found to be present in 5 (2.92%) neonates while in group 2, 19 (11.11 %) neonates had polycythemia (p-value=0.003). High bilirubin in group 1 was present in 7 (4.09 %) of neonates while 33 (19.30 %) neonates in group 2 had high bilirubin.(p-value=0.001) Conclusion: Our study showed that neonates with late clamping had lower incidence of anaemia, higher haematocrit as compared to early clamping but were prone to a higher levels of bilirubin as well as polycythemia. Significant variations for haematocrit, polycythemia and bilirubin were found