IMPACT OF EARLY VERSUS DELAYED CLAMPING ON SERUM FERRITIN LEVEL OF NEWBORN; 48 HOURS AFTER BIRTH

Background: Iron deficiency and iron deficiency anemia are major public health problems in young children worldwide, and are associated with poor neurodevelopment. Delayed umbilical cord clamping has been suggested as a measure to prevent infant iron deficiency, but we lack data concerning its health benefits and possible adverse effects, especially in the developing world. Objective: To evaluate the effect of early versus delayed clamping on the serum ferritin level of newborn; 48 hours after birth Methodology: This prospective cohort was conducted upon a sample of 400 mother-infant pairs scheduled to undergo delivery at Indus Medical College, Hospital from January 2018 to December 2018. The mother-infant pairs were randomly assigned to delayed clamping (2 min after delivery of the infant's shoulders) or early clamping (around 10 s after delivery). Primary outcomes were infant hematological status and iron status at 48 hours after birth. The data obtained was recorded onto a structured questionnaire and analyzed using SPSS v.21 & Microsoft Excel 2016. Results: The mean age of the mothers stood at 34 (SD ± 4.9). Maternal hematological status was assessed upon admission to the delivery room. The groups had similar demographic and biomedical characteristics at baseline. 200 infants were born vaginally and 200 were delivered by cesarean section. Forty-eight hours after delivery the mean infant hemoglobin, hematocrit and serum ferritin levels were significantly higher in the delayed clamping group versus the early clamping group. Conclusion: After careful consideration, it can be concluded that delaying cord clamping increases the red cell mass in term infants. It is a safe, simple and low cost delivery procedure that should be incorporated in integrated programs that are aimed at reducing iron deficiency anemia in infants in developing countries. Vaginal delivery facilitates this action. Keywords: Iron Deficiency, Vaginal Delivery, Umbilical Cord Clamping, Serum Ferritin & Red Cell Mass