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LETTER TO EDITOR
Year : 2016  |  Volume : 5  |  Issue : 1  |  Page : 69

Dispute on delayed cord clamping


1 Department of Pediatrics, VMMC and Safdarjung Hospital, New Delhi, India
2 Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital, New Delhi, India

Date of Web Publication6-Jan-2016

Correspondence Address:
Manas Pratim Roy
Department of Pediatrics, VMMC and Safdarjung Hospital, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4847.173273

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How to cite this article:
Roy MP, Rani K U, Gupta R, Salhan M. Dispute on delayed cord clamping. J Clin Neonatol 2016;5:69

How to cite this URL:
Roy MP, Rani K U, Gupta R, Salhan M. Dispute on delayed cord clamping. J Clin Neonatol [serial online] 2016 [cited 2019 Dec 15];5:69. Available from: http://www.jcnonweb.com/text.asp?2016/5/1/69/173273

Sir,

We read with interest the research article on delayed cord clamping (DCC).[1] The authors did a commendable job by raising the controversial timing of cord clamping. However, there are certain queries.

  • The World Health Organization recommends cord clamping 1 – 3 minutes after birth (strong recommendation).[2] Federation of Obstetric and Gynaecological Societies of India also recommends delaying clamping by at least 30 – 40 seconds.[3] Therefore, the justification of clamping as early as 10 second after birth in the first group is not clear. Was it done to enhance difference between two groups?
  • [Table 3] suggests significant difference between the groups in mean respiratory rate at 1h and 12h, in terms of p value. But result section suggests otherwise.
  • Anemia estimation could have been done at a later date. Two previous studies cited in the article from India documented haemoglobin level three months after birth.[4],[5] A recent article also compared haemoglobin at six weeks of age.[6]
  • What type of regression was used in analysis? How did the authors assess fit of the model?
  • For hyperbilirubinemia, although p value is not significant, the rate of phototherapy required is more than twice (18.9%) in DCC group in comparison to ECC group (7.7%). This should be noted with caution.


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Krishnan L, Kommu PP, Thomas BJ, Akila B, Daniel M. Should delayed cord clamping be the standard of care in term low risk deliveries? A randomized controlled trial from a medical college hospital in South India. J Clin Neonatol 2015;4:183-7.  Back to cited text no. 1
  Medknow Journal  
2.
World Health Organization. WHO Recommendations for the Prevention and Treatment of Postpartum Haemorrhage. Italy: World Health Organization; 2012.  Back to cited text no. 2
    
3.
Lalonde A. International Federation of Gynecology and Obstetrics Prevention and treatment of postpartum hemorrhage in low-resource settings. Int J Gynaecol Obstet 2012;117:108-18.  Back to cited text no. 3
    
4.
Gupta R, Ramji S. Effect of delayed cord clamping on iron stores in infants born to anemic mothers: A randomized controlled trial. Indian Pediatr 2002;39:130-5.  Back to cited text no. 4
    
5.
Geethanath RM, Ramji S, Thirupuram S, Rao YN. Effects of timing of cord clamping on the iron stores of infants at 3 months. Indian Pediatr 1997;34:103-6.  Back to cited text no. 5
    
6.
Kumar B, Upadhyay A, Gothwal S, Jaiwal V, Joshi P, Dubey K. Umbilical cord milking and hematological parameters in moderate to late preterm neonates: A randomized control trial. Indian Pediatr. 2015;52:753-7.  Back to cited text no. 6
    




 

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