Brief Delay in Cord Clamping and Neurobehaviour in Preterms

A Randomised Controlled Trial to Evaluate the Role of Brief Delay in Cord Clamping in Preterm Neonates (34-36weeks) on Short Term Neurodevelopmental Outcome

RESEARCH HYPOTHESIS Brief delay(>30 sec to <60 sec ) in cord clamping as compared to early cord clamping (< 20 sec) leads to a better short term neurobehavioural outcome in preterm (34-36 wks) neonates when assessed by neurobehavioral assessment of preterm infants (n.a.p.i.) at 37 weeks of post conceptional age

Delayed cord clamping (DCC) : Well described phenomenon in term infants . The optimal timing of clamping of umbilical cord in preterm infants : A subject of debate. Even a brief delay in cord clamping leads to an additional transfer of iron amounting to 40-50 mg/kg which may prevent iron deficiency.¹ This low cost intervention can have significant public health importance in resource constrained settings. The effect of this intervention on neurobehaviour of preterm neonates has not been assessed. This aspect has been identified by WHO and Cochrane as a potentially researchable area

Inclusion Criteria: All preterm deliveries -infants born at 34 weeks 0 days to 36 weeks +6 days gestational age as estimated by last menstrual period or early ultrasound scan. Infants delivered vaginally or by caesarean section in cephalic presentation Singleton pregnancy Parental consent Exclusion Criteria: Fetus with gross congenital anomaly Fetus with hydrops Rh negative pregnancy