Effect of Delayed Cord Clamping on Hemoglobin Levels and Jaundice Requiring Phototherapy in Term & Late Preterm Neonates: An Observational Study in a Tertiary Care Centre, North India

Abstract

Background: Delayed cord clamping (DCC) improves neonatal iron status, but concerns remain about jaundice requiring phototherapy.

Objective: To examine the association of DCC with hemoglobin levels at 24 hours and incidence of phototherapy in term and late preterm neonates.

Methods: Prospective observational study at a tertiary centre in North India (Jan–Dec 2024). Neonates ≥34 weeks were grouped into Early Cord Clamping (ECC, ≤30 s) and DCC (60–120 s). Hemoglobin was measured from venous blood using an automated analyzer at 24 h. Bilirubin was measured by serum assay every 24 h until day 5; phototherapy initiated per AAP nomogram. Adjusted regression analyses were performed.

Results: 200 neonates (100 ECC, 100 DCC). Mean Hb higher in DCC (16.9 g/dL) vs ECC (15.4 g/dL); mean difference +1.5 g/dL (95% CI: +1.1 to +1.9, p<0.001, Cohen’s d=0.97). Phototherapy requirement: 14% vs 10% (risk difference +4%, 95% CI: –5% to +13%, p=0.42). Adjusted logistic regression showed no significant association between DCC and phototherapy (aOR 1.4, 95% CI: 0.6–3.2)

Conclusion: DCC is associated with significantly higher neonatal hemoglobin at 24 hours, with no statistically significant increase in phototherapy requirement.