Anemia Clinical Trial
Official title:
Placental Transfusion in Term Infants Placed Skin-to-Skin: A Pilot Controlled Trial
The proposed study is a pilot prospective controlled trial to measure the blood volume left in the placenta after varying cord clamping times when the infant is placed skin-to-skin on the maternal abdomen. Delaying cord clamping has been shown to decrease anemia in infants. However, the best way to get the most blood to the baby is not known. The practice of cord clamping at birth is not the same among doctors and midwives and we do not know the effect of putting he baby on the mother's abdomen.
The proposed study is a pilot prospective controlled trial to measure the placental residual
blood volume after varying cord clamping protocols when the infants are placed skin-to-skin
on the maternal abdomen. The study assessed compliance of the providers with the different
protocols. Placental transfusion (PT) has been shown to increase infant body iron stores at
6 months of age without increasing adverse outcomes. However, the optimal protocol to
achieve adequate placental transfusion is not known. The practice of cord clamping at birth
is not uniform among obstetrical providers because adequate evidence to support early or
late cord clamping has been lacking.
Women were eligible to enroll in the study if they had no pregnancy complications, did not
smoke, planned to breastfeed, and planned to deliver vaginally between 37 and 416/7 weeks.
Women were enrolled prenatally on the labor and delivery unit. At birth, women were assigned
to one of four cord clamping/milking groups. A cohort of infants with immediate cord
clamping serves as reference group. Infants had blood samples drawn with the routine newborn
screening blood samples done at 36 to 48 hours. Information on infant health and feeding was
completed through an in-hospital visit to the mother and by home visit at two weeks of age.
The primary outcome measures were placental residual blood volume and compliance with the
various assigned cord clamping protocols. It was expected that infants with delayed cord
clamping or cord milking would have less placental residual blood volume and that most
providers would comply with the various random assignments.
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Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Factorial Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Prevention
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