Effect of Time of Cord Clamping on the Serum Bilirubin Level among Full-Term Babies Born in an Ethiopian Hospital Setting: An Exploratory Three-Arm Randomized Controlled Trial

Background. Delayed cord clamping (DCC) for more than one minute is associated with nutritional and developmental benefits for newborns. However, there is limited evidence regarding the relationship between DCC and outcomes in resource-limited settings. This study aims to assess the effect of the ti...

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Main Authors: Biruk Hailu Tesfaye, Mulugeta Betre Gebremariam, Abiy Seifu Estifanos, Asrat D. Gebremedhin
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:International Journal of Clinical Practice
Online Access:http://dx.doi.org/10.1155/2024/2564545
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author Biruk Hailu Tesfaye
Mulugeta Betre Gebremariam
Abiy Seifu Estifanos
Asrat D. Gebremedhin
author_facet Biruk Hailu Tesfaye
Mulugeta Betre Gebremariam
Abiy Seifu Estifanos
Asrat D. Gebremedhin
author_sort Biruk Hailu Tesfaye
collection DOAJ
description Background. Delayed cord clamping (DCC) for more than one minute is associated with nutritional and developmental benefits for newborns. However, there is limited evidence regarding the relationship between DCC and outcomes in resource-limited settings. This study aims to assess the effect of the time of cord clamping on serum bilirubin level 24 hours after birth in an Ethiopian Tertiary Care hospital. Methods. A three-arm, single-blind, exploratory randomized controlled trial was conducted between October 2019 and January 2020 targeting healthy, full-term neonates. Study participants were randomly assigned into one of the following intervention groups depending on the timing of cord clamping: immediate cord clamping (<30 seconds), intermediate cord clamping (60 seconds), and DCC (180 seconds). The primary outcome is serum bilirubin level in the newborns, which was assessed 24 hours after birth and before they were discharged home. Descriptive analysis was applied to assess differences between groups in terms of demographic, obstetric, and social characteristics of the participants, while a linear regression model was employed to examine the association between cord clamping time and serum bilirubin level. Result. A total of 141 term newborns were included and randomized into the three categories. The demographic, social, and obstetrics characteristics of included participants were not different across groups except for the labor duration (P value <0.05). While the time of cord clamping was not a significant predictor of total serum bilirubin levels at 24 hours postbirth, cord blood total serum bilirubin (coefficient: 0.24; p<0.05) and bilirubin nomogram high-risk zone (coefficient: 6.25; p<0.001) were found to be significant predictors. (4) Conclusion. Our findings indicate that the time of umbilical cord clamping does not affect the total serum bilirubin level of neonates at least within 24 hours of birth.
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spelling doaj-art-8c561202df8740e08fe3b38a77462b2c2025-02-03T11:37:51ZengWileyInternational Journal of Clinical Practice1742-12412024-01-01202410.1155/2024/2564545Effect of Time of Cord Clamping on the Serum Bilirubin Level among Full-Term Babies Born in an Ethiopian Hospital Setting: An Exploratory Three-Arm Randomized Controlled TrialBiruk Hailu Tesfaye0Mulugeta Betre Gebremariam1Abiy Seifu Estifanos2Asrat D. Gebremedhin3MaternalSchool of Public HealthSchool of Public HealthDepartment of NeonatologyBackground. Delayed cord clamping (DCC) for more than one minute is associated with nutritional and developmental benefits for newborns. However, there is limited evidence regarding the relationship between DCC and outcomes in resource-limited settings. This study aims to assess the effect of the time of cord clamping on serum bilirubin level 24 hours after birth in an Ethiopian Tertiary Care hospital. Methods. A three-arm, single-blind, exploratory randomized controlled trial was conducted between October 2019 and January 2020 targeting healthy, full-term neonates. Study participants were randomly assigned into one of the following intervention groups depending on the timing of cord clamping: immediate cord clamping (<30 seconds), intermediate cord clamping (60 seconds), and DCC (180 seconds). The primary outcome is serum bilirubin level in the newborns, which was assessed 24 hours after birth and before they were discharged home. Descriptive analysis was applied to assess differences between groups in terms of demographic, obstetric, and social characteristics of the participants, while a linear regression model was employed to examine the association between cord clamping time and serum bilirubin level. Result. A total of 141 term newborns were included and randomized into the three categories. The demographic, social, and obstetrics characteristics of included participants were not different across groups except for the labor duration (P value <0.05). While the time of cord clamping was not a significant predictor of total serum bilirubin levels at 24 hours postbirth, cord blood total serum bilirubin (coefficient: 0.24; p<0.05) and bilirubin nomogram high-risk zone (coefficient: 6.25; p<0.001) were found to be significant predictors. (4) Conclusion. Our findings indicate that the time of umbilical cord clamping does not affect the total serum bilirubin level of neonates at least within 24 hours of birth.http://dx.doi.org/10.1155/2024/2564545
spellingShingle Biruk Hailu Tesfaye
Mulugeta Betre Gebremariam
Abiy Seifu Estifanos
Asrat D. Gebremedhin
Effect of Time of Cord Clamping on the Serum Bilirubin Level among Full-Term Babies Born in an Ethiopian Hospital Setting: An Exploratory Three-Arm Randomized Controlled Trial
International Journal of Clinical Practice
title Effect of Time of Cord Clamping on the Serum Bilirubin Level among Full-Term Babies Born in an Ethiopian Hospital Setting: An Exploratory Three-Arm Randomized Controlled Trial
title_full Effect of Time of Cord Clamping on the Serum Bilirubin Level among Full-Term Babies Born in an Ethiopian Hospital Setting: An Exploratory Three-Arm Randomized Controlled Trial
title_fullStr Effect of Time of Cord Clamping on the Serum Bilirubin Level among Full-Term Babies Born in an Ethiopian Hospital Setting: An Exploratory Three-Arm Randomized Controlled Trial
title_full_unstemmed Effect of Time of Cord Clamping on the Serum Bilirubin Level among Full-Term Babies Born in an Ethiopian Hospital Setting: An Exploratory Three-Arm Randomized Controlled Trial
title_short Effect of Time of Cord Clamping on the Serum Bilirubin Level among Full-Term Babies Born in an Ethiopian Hospital Setting: An Exploratory Three-Arm Randomized Controlled Trial
title_sort effect of time of cord clamping on the serum bilirubin level among full term babies born in an ethiopian hospital setting an exploratory three arm randomized controlled trial
url http://dx.doi.org/10.1155/2024/2564545
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