Effects of delayed versus early umbilical cord clamping on newborns' hematological profile: Quasi-experimental study among Palestinian newborns

Goal: The goal of the study is to evaluate and compare the effects of delayed umbilical cord clamping (DCC) versus early umbilical cord clamping (ECC) on neonatal hematological profile among Palestinian newborns in Gaza Strip, Palestine. 

Methodology: The researcher used quasi-experimental design. The sample of the study was a purposive sample, consisted of 100 full-term newborns who underwent ECC and 100 newborns who underwent DCC. The study was conducted in labor department at AL-Emirate hospital. For data collection, the researcher used constructive questionnaire and blood samples from the infants (after birth and after one year). The researcher used SPSS version 25 for data analysis. Statistical analysis included frequencies, percentage, mean scores, t-test, and One way ANOVA. 

Results: The results showed that 88% of mothers from the DCC group and 87% of mothers from the ECC group received folic acid during pregnancy and 90% of mothers from the DCC group and 81% of mothers from the ECC group received iron supplement during pregnancy, 59% of newborns from the DCC group and 55% of newborns from the ECC group were males, 92% of newborns from each group have a one-minute APGAR score (7 – 10). CBC analysis after birth showed that the newborns from the DCC group have significant higher hemoglobin compared to newborns from the ECC group (15.064±2.343g and 14.417±1.689g, p-value 0.026). Also, the newborns from the DCC group have significant higher Red Blood Cells compared to newborns from the ECC group (3.886±0.717 and 3.244±0.687g, p-value 0.000). After one year, infants from the DCC group showed significant higher hemoglobin than infants from the ECC group (13.363±0.673 and 12.681±0.845, p-value 0.000), significant higher hematocrit (40.486±3.003 and 38.257±3.548, p-value 0.000), significant higher RBCs (4.290±0.444 and 3.752±0.492, p-value 0.000), significant higher MCV (111.313±4.479 and 103.761±10.800, p-value 0.000), significant lower WBC (8.339±2.067 and 9.554±2.709, p-value 0.002), and significant higher platelets count (363.547±73.222 and 317.222±83.354, p-value 0.000). There were statistically no significant differences in Hgb level of newborns' from the DCC group related to gender, while newborns with one-minute APGAR score less than 7 showed significant lower CBC results after birth but no significant differences after one year. Also, newborns who have been admitted to NICU showed significant lower CBC results after birth and after one year. The study concluded that newborns who underwent DCC showed better Hgb and MCV, which means that they have better iron storage. The study recommends the use of DCC approach in term infants.