Effect of delayed cord clamping on neonatal resuscitation

Objective To investigate the effect of delayed cord clamping on outcomes of neonatal resuscitation. Methods Totally, 7 429 full term infants born in the Maternal and Child Health Care Hospital of Jilin from January 2013 to January 2015 were randomly divided into two groups, the observation group (n=3 727) and the control (n=3 702). The cords were clamped 2 min delayed in the former group, while those in the latter group were clamped within 10 s after birth. The rate of asphyxia and successful resuscitation, Apgar score at 1 and 5 min after birth, and pH value, base excess (BE), blood glucose, cardiac troponin (cTn) I at 1 h after birth were compared with t-test or Chi-square test. Results The incidence of neonatal asphyxia in the observation group was lower than in the control [0.75%(28/3 727) vs 1.21%(45/3 702), χ2=4.115, P 0.05]. In observation group, those newborns who suffered from severe asphyxia had higher Apgar score at 1 and 5 min than control (1 min: 2.80±0.45 vs 2.08±0.67, t=2.181; 5 min: 8.00±1.00 vs 6.25±1.66, t=2.176; both P 0.05). For those babies with severe asphyxia, the blood pH, BE, blood glucose and cTnI levels in the observation group were significantly different from the control group [7.08±0.29 vs 7.02±0.56, (-16.82±0.60) vs (-17.43±0.35) mmol/L, (7.93±0.78) vs (8.02±0.53) mmol/L and (0.203±0.041) vs (0.249±0.035) ng/ml, t=2.270, 2.387, -2.371 and -2.341, all P<0.05]. Conclusion Two minutes delayed in cord clamping could help to reduce the incidence of asphyxia and improve the effect of resuscitation in severe asphyxia. Key words: Delayed diagnosis; Umbilical cord; Ligation; Resuscitation; Asphyxia neonatorum