A 30 to 60 second delay in umbilical cord clamping for full-term and preterm neonates improves neonatal hemoglobin levels 24-48 hours after birth, leads to greater iron stores for 3-6 month olds, and improved neurodevelopmental scores through 4 years. Data for maternal outcomes, however, are underrepresented in the literature, especially for women undergoing cesarean sections. In order to compare maternal blood loss in women with scheduled cesarean deliveries (>37 weeks), 113 women with singleton gestations (mean age, 32.6 years) were randomized to immediate cord clamping (n=56) or delayed cord clamping (n=57). There was no significant difference in maternal hemoglobin levels from preoperative to postoperative day 1 between groups; the mean hemoglobin change was -1.90 g/dL and -1.78 g/dL in the delayed and immediate cord clamping groups, respectively. Furthermore, the neonatal hemoglobin levels were significantly higher with delayed clamping (18.1 g/dL) compared to immediate cord clamping (16.4 g/dL; P<0.001). Data from this randomized clinical trial is consistent with data from women delivering vaginally and confirms the safety of delayed umbilical cord clamping for women delivering full-term neonates by cesarean sections. Further studies should assess the safety in emergency cesareans and pre-term neonates.
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