Delayed umbilical cord clamping effects on caesarean delivery neonates
under general anaesthesia: A prospective cohort study
Abstract
Objective: To investigate the effect of delayed umbilical cord clamping
on neonatal outcomes following caesarean delivery under general
anaesthesia. Design: Prospective cohort study. Setting: West China
Second University Hospital Sample: Neonates born by caesarean delivery
under general anaesthesia after 35 gestational weeks. Methods: Neonates
were assigned to Groups A or B if they received early or delayed cord
clamping, respectively. Main Outcome Measures: Umbilical arterial blood
gas analysis indicators, Apgar scores, resuscitation procedure
incidence, peak bilirubin, and neonatal morbidity were compared between
the two groups. Results: Group A had 29 and Group B had 21 participants.
There were no significant differences in any of the outcome measures
between the two groups. We classified five periods during caesarean
delivery: aesthetic induction (Period 1), skin incision (Period 2),
myometrium incision (Period 3), delivery of the neonate (Period 4), and
time of cord clamping (Period 5). One-minute Apgar scores were
negatively correlated with cord-clamping time (r=-0.426, P=0.002). Peak
bilirubin value was correlated with Periods 2, 3, and 5 (r=0.347,
P=0.014; r=0.411, P=0.003; r=-0.289, P=0.042, respectively). The
remaining secondary outcomes were not correlated with any of the five
periods. The peak bilirubin value was(9.712+0.006 × Period 2+0.006 ×
Period 3-0.026 × Period 5) (R2=0.313). . Conclusions: In caesarean
delivery under general anaesthesia, delayed cord clamping within a
certain period may partially prolong the duration of neonatal exposure
to general anaesthesia drugs. However, delayed cord clamping is a safe
and feasible technique for clinical application.