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Effect of Delayed Cord Clamping on Neurodevelopment at 3 Years : A Randomized Controlled Trial

Berg, Johan Henrik Martin LU orcid ; Isacson, Manuela LU ; Basnet, Omkar ; Gurung, Rejina ; Subedi, Kalpana ; Kc, Ashish and Andersson, Ola LU orcid (2021) In Neonatology 118(3). p.282-288
Abstract

INTRODUCTION: Iron deficiency (ID) is associated with poor neurodevelopment. We have previously shown that delayed umbilical cord clamping (CC) improves iron stores at 8 months and neurodevelopment at 1 year in term, healthy infants in Nepal.

OBJECTIVE: The aim of this study was to assess the effects of delayed CC (≥180 s) compared to early CC (≤60 s) on neurodevelopment using the Ages and Stages Questionnaire (ASQ) at age 3 years.

METHODS: In 2014, 540 healthy Nepalese infants born at term were randomized in a 1:1 ratio to delayed or early CC. At 3 years of age, ASQ assessment was performed by phone interviews with parents. A score >1 standard deviation below the mean was defined as "at risk" for developmental... (More)

INTRODUCTION: Iron deficiency (ID) is associated with poor neurodevelopment. We have previously shown that delayed umbilical cord clamping (CC) improves iron stores at 8 months and neurodevelopment at 1 year in term, healthy infants in Nepal.

OBJECTIVE: The aim of this study was to assess the effects of delayed CC (≥180 s) compared to early CC (≤60 s) on neurodevelopment using the Ages and Stages Questionnaire (ASQ) at age 3 years.

METHODS: In 2014, 540 healthy Nepalese infants born at term were randomized in a 1:1 ratio to delayed or early CC. At 3 years of age, ASQ assessment was performed by phone interviews with parents. A score >1 standard deviation below the mean was defined as "at risk" for developmental impairment.

RESULTS: At 3 years of age, 350 children were followed up, 170 (63.0%) in the early CC group and 180 (66.7%) in the delayed CC group. No significant differences in ASQ scores in any domains between groups were found. However, more girls were "at risk" for affected gross motor development in the early CC group: 14 (18.9%) versus 6 (6.3%), p = 0.02.

CONCLUSION: There were no significant differences in ASQ scores in any domains between groups. In the subgroup analysis, fewer girls who underwent delayed CC were "at risk" for delayed gross motor development. Due to the pronounced difference in iron stores at 8 months postpartum in this cohort, follow-up studies at an older age are motivated since neurodevelopmental impairment after early ID may be more detectable with increasing age.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Neonatology
volume
118
issue
3
pages
282 - 288
publisher
Karger
external identifiers
  • scopus:85107501361
  • pmid:33965945
ISSN
1661-7800
DOI
10.1159/000515838
project
Cord clamping when infants in need of resuscitation are born - neurodevelopmental outcomes and other perspectives
The effects of pre-, peri- and postnatal factors on the infant’s health and neurodevelopment
language
English
LU publication?
yes
id
931c60bf-cae1-4732-aee9-7164308289ea
date added to LUP
2021-05-16 16:34:36
date last changed
2025-04-06 16:05:41
@article{931c60bf-cae1-4732-aee9-7164308289ea,
  abstract     = {{<p>INTRODUCTION: Iron deficiency (ID) is associated with poor neurodevelopment. We have previously shown that delayed umbilical cord clamping (CC) improves iron stores at 8 months and neurodevelopment at 1 year in term, healthy infants in Nepal.</p><p>OBJECTIVE: The aim of this study was to assess the effects of delayed CC (≥180 s) compared to early CC (≤60 s) on neurodevelopment using the Ages and Stages Questionnaire (ASQ) at age 3 years.</p><p>METHODS: In 2014, 540 healthy Nepalese infants born at term were randomized in a 1:1 ratio to delayed or early CC. At 3 years of age, ASQ assessment was performed by phone interviews with parents. A score &gt;1 standard deviation below the mean was defined as "at risk" for developmental impairment.</p><p>RESULTS: At 3 years of age, 350 children were followed up, 170 (63.0%) in the early CC group and 180 (66.7%) in the delayed CC group. No significant differences in ASQ scores in any domains between groups were found. However, more girls were "at risk" for affected gross motor development in the early CC group: 14 (18.9%) versus 6 (6.3%), p = 0.02.</p><p>CONCLUSION: There were no significant differences in ASQ scores in any domains between groups. In the subgroup analysis, fewer girls who underwent delayed CC were "at risk" for delayed gross motor development. Due to the pronounced difference in iron stores at 8 months postpartum in this cohort, follow-up studies at an older age are motivated since neurodevelopmental impairment after early ID may be more detectable with increasing age.</p>}},
  author       = {{Berg, Johan Henrik Martin and Isacson, Manuela and Basnet, Omkar and Gurung, Rejina and Subedi, Kalpana and Kc, Ashish and Andersson, Ola}},
  issn         = {{1661-7800}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{3}},
  pages        = {{282--288}},
  publisher    = {{Karger}},
  series       = {{Neonatology}},
  title        = {{Effect of Delayed Cord Clamping on Neurodevelopment at 3 Years : A Randomized Controlled Trial}},
  url          = {{http://dx.doi.org/10.1159/000515838}},
  doi          = {{10.1159/000515838}},
  volume       = {{118}},
  year         = {{2021}},
}