Timing of Umbilical Cord Clamping in Preterm Neonates

NCT ID: NCT06000800

Last Updated: 2023-08-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

4 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-11-18

Study Completion Date

2022-12-21

Brief Summary

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Umbilical cord clamping is an important intervention that routinely done for all neonates afterbirth. yet the optimal timing for this intervention remains controversial

Detailed Description

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The study was a randomized controlled trial to assess the effect of timing of umbilical cord clamping on preterm neonatal outcome together The study was conducted in Kasr Al Ainy maternity hospital, Cairo university hospitals which provides free obstetrics and gynecology health services including antepartum, intraparturm, postpartum, and neonatal care for both low risk and high-risk pregnant women A total of 80 pregnant women out of 120 meeting the eligibility criteria were randomly pooled using computer-generated random numbers.

The 80 randomly recruited ladies were randomly allocated using sealed envelopes to a group from 4 equal groups (group A, B, C, and D) of 20 ladies each. Umbilical cord clamping was performed immediately after birth (5 second) in group A, at 30 seconds in group B, at 60 seconds in group C, and at 90 seconds in group D.The trial was unblinded; where the participants and researchers were aware of the group a participant belonged to.

After the study protocol was granted the ethical approval from the research ethical committee of Faculty of Nursing, Cairo University, Egypt, a written informed consent was obtained form mothers of preterm neonate who met the inclusion criteria including the aim, procedure, benefits, and nature of the study .The anonymity and confidentiality of information was assured, and the mothers had the right to withdraw from the study at any time during the study without any effect on the care provided to their preterm neonates.

All study subjects were interviewed using a Structured interview questionnaire to obtain full history to assess participants' demographic data such as age, residence, educational level and occupation, past medical and surgical history, and obstetric history such as gravidity, parity, and current pregnancy antenatal care.

Immediately after birth, neonates in all groups are held 20 cm below the incision level.For neonates in group A,umbilical cord was clamped and cut immediately after birth (5 second); while, neonates in group B, umbilical cord were clamped and cut at 30 seconds. For neonates in group C, umbilical cord was clamped and cut at 60 seconds. And finally, neonates in group D, umbilical cord were clamped and cut at 90 seconds. After cord clamping, all neonates were subject to routine immediate care.

Neonatal data recorded included neonatal characteristic such as gestational age,birth weight and gender.Neonatal condition was assessed and documented immediately after birth through applying APGAR score of neonatal life, birth weight was measured immediately after delivery through birth scale. Vital signs (respiration, pulse \& temperature) were measured birth.

A pilot study was conducted on 10% of the study subjects. Eight preterm neonates who met the inclusion criteria; the pilot study was carried out to test the clarity of the tool's questions, and time needed to complete the tools. Additionally, to examine the applicability of the study tool, and to identify any difficulties that may arise and need to be handled before data collection. The pilot study revealed that the tools did not require modification. The sample included in the pilot study was excluded from the main study sample.

The collected data will be coded and statistically analyzed to obtain mean and standard deviation for quantitative variables and frequencies (number of cases) and relative frequencies (percentages) for categorical variables. Comparisons between groups will bedone using analysis of variance (ANOVA) with multiple comparisons post hoc test in normally distributed quantitative variables while non-parametric Kruskal-Wallis test and Mann-Whitney test will be used for non-normally distributed quantitative variables . For comparing categorical data, Chi square test will be performed.

Conditions

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Cord Clamping

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A randomized controlled trial was used to fulfill the aim of the study. The randomized control trial (RCT) is a trial in which subjects are randomly assigned to one of two groups: one (the experimental group) receiving the intervention that is being tested, and the other (the comparison group or control group) receiving an alternative treatment
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

The trial was unblinded; where the participants and researchers were aware of the group a participant belonged to

Study Groups

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Group (clamping at 30 seconds)

Umbilical cord clamping at 30 seconds

Group Type EXPERIMENTAL

Group B

Intervention Type OTHER

Umbilical cord clamping at 30 seconds

Group clamping at 60 seconds

Umbilical cord clamping at 60 seconds

Group Type EXPERIMENTAL

Group C

Intervention Type OTHER

Umbilical cord clamping at 60 seconds

Group clamping at 90 seconds

Umbilical cord clamping at 90 seconds

Group Type EXPERIMENTAL

Group D

Intervention Type OTHER

Umbilical cord clamping at 90 seconds

Group clamping immediately

Umbilical cord clamping immediately after birth (5 second)

Group Type ACTIVE_COMPARATOR

Group A

Intervention Type OTHER

Umbilical cord clamping immediately after birth (5 second)

Interventions

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Group B

Umbilical cord clamping at 30 seconds

Intervention Type OTHER

Group C

Umbilical cord clamping at 60 seconds

Intervention Type OTHER

Group D

Umbilical cord clamping at 90 seconds

Intervention Type OTHER

Group A

Umbilical cord clamping immediately after birth (5 second)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* healthy pregnant mothers
* singleton fetuses
* preterm cesarian delivery

Exclusion Criteria

* asphyxiated neonates
* twins
* mothers with any medical or obstetrical conditions occurring intrapartum such as hemorrhage, or eclampsia.
Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Cairo University

OTHER

Sponsor Role lead

Responsible Party

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Fatma Zaghloul

Lecturer of maternal and newborn health nursing

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Lawahez M. Dwedar, lecturer

Role: STUDY_CHAIR

faculty of nursing

Fatma Atta, lecturer

Role: STUDY_CHAIR

faculty of medicine

Locations

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Faculty of nursinf

Cairo, , Egypt

Site Status

Countries

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Egypt

References

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Alzaree F, Elbohoty A, Abdellatif M. Early Versus Delayed Umbilical Cord Clamping on Physiologic Anemia of the Term Newborn Infant. Open Access Maced J Med Sci. 2018 Aug 15;6(8):1399-1404. doi: 10.3889/oamjms.2018.286. eCollection 2018 Aug 20.

Reference Type BACKGROUND
PMID: 30159064 (View on PubMed)

American College of Obstetricians and Gynecologists' Committee on Obstetric Practice. Delayed Umbilical Cord Clamping After Birth: ACOG Committee Opinion, Number 814. Obstet Gynecol. 2020 Dec;136(6):e100-e106. doi: 10.1097/AOG.0000000000004167.

Reference Type BACKGROUND
PMID: 33214530 (View on PubMed)

Kc A, Rana N, Malqvist M, Jarawka Ranneberg L, Subedi K, Andersson O. Effects of Delayed Umbilical Cord Clamping vs Early Clamping on Anemia in Infants at 8 and 12 Months: A Randomized Clinical Trial. JAMA Pediatr. 2017 Mar 1;171(3):264-270. doi: 10.1001/jamapediatrics.2016.3971.

Reference Type BACKGROUND
PMID: 28114607 (View on PubMed)

Bianchi A, Jacobsson B, Mol BW; FIGO Working Group for Preterm Birth. FIGO good practice recommendations on delayed umbilical cord clamping. Int J Gynaecol Obstet. 2021 Oct;155(1):34-36. doi: 10.1002/ijgo.13841.

Reference Type BACKGROUND
PMID: 34520061 (View on PubMed)

Brown BE, Shah PS, Afifi JK, Sherlock RL, Adie MA, Monterrosa LA, Crane JM, Ye XY, El-Naggar WI; Canadian Neonatal Network; Canadian Preterm Birth Network Investigators. Delayed cord clamping in small for gestational age preterm infants. Am J Obstet Gynecol. 2022 Feb;226(2):247.e1-247.e10. doi: 10.1016/j.ajog.2021.08.003. Epub 2021 Aug 9.

Reference Type BACKGROUND
PMID: 34384773 (View on PubMed)

Chiruvolu A, Mallett LH, Govande VP, Raju VN, Hammonds K, Katheria AC. Variations in umbilical cord clamping practices in the United States: a national survey of neonatologists. J Matern Fetal Neonatal Med. 2022 Oct;35(19):3646-3652. doi: 10.1080/14767058.2020.1836150. Epub 2020 Oct 20.

Reference Type BACKGROUND
PMID: 33081557 (View on PubMed)

Deindl P, Diemert A. From structural modalities in perinatal medicine to the frequency of preterm birth. Semin Immunopathol. 2020 Aug;42(4):377-383. doi: 10.1007/s00281-020-00805-0. Epub 2020 Aug 25.

Reference Type BACKGROUND
PMID: 32840641 (View on PubMed)

Other Identifiers

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Cord Clamping

Identifier Type: -

Identifier Source: org_study_id

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