Abstract

CERIANI CERNADAS, JoséM et al. The effect ofearly and delayed umbilical cord clamping on ferritin levels in term infants atsix months of life: A randomized, controlled trial. Arch. argent. pediatr. [online]. 2010, vol.108, n.3, pp.201-208. ISSN 0325-0075.

Background. Delayed umbilical cord clamping could increase iron storesand prevent iron deficiency in infants. To test this hypothesis we measuredserum ferritin and hemoglobin levels at six months of age in term infants whohad participated in a randomized controlled trial, assessing the effect of cordclamping timing on neonatal hematocrit values and clinical outcome. Mainoutcome measure. Serum ferritin level at six months of age.Methods. Out of the 276 mothers and their infants thatparticipated in the initial study, 255 (92.4%) were followed up to six monthsand included in this study. Of these, 86 had their cords clamped within thefirst 15 seconds (early clamping), 83 at one minute, and 83 at three minutes.The pediatricians in charge of the evaluations during the follow-up period andpersonnel in charge of the biochemical tests were blinded to the assignmentgroup. In all but 3 infants the ferritin levels and hemoglobin levels weremeasured at six months of age.Results. Mothers and infants in the three groups hadsimilar baseline characteristics. Serum ferritin levels were significantlyhigher in the infants of the three minutes group than in the infants of theearly group: 33.2 μg/Lvs. 20.9 μg/L (geometric meanratio: 1.6; 95% CI: 1.2 to 2.11) but no difference was observed in one minutegroup (25.5 μg/L) vs. early group.There were no significant differences in mean hemoglobin values, 10.6 g/dl (SD1,1); 10.8 g/dl (SD 0.9) and 10.7 g/dl (SD 1.0) between groups early, oneminute, and three minutes, respectively. Although there were no significantdifferences between groups, the prevalence of iron deficiency anemia(hemoglobin < 10.5 g/dl and ferritin < 9 μg/L) was 3 times more frequent inearly clampling group (7.2%) than in three minutes group (2.4%) (RR: 0.30; IC95%: 0.10-1.60).Conclusions. Delayed umbilical cord clamping at threeminutes significantly increases serum ferritin levels in infants at 6 months ofage. No significant differences were found between groups in mean hemoglobinlevels.

Keywords : Umbilical cord clamping; Infants; Serum ferritin; Hemoglobinlevels.

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