Association of a Delayed Cord-Clamping Protocol With Hyperbilirubinemia in Term Neonates
OBJECTIVE:To evaluate the implementation of a delayed cord-clamping protocol at an academic medical center, and its short-term associations on term neonates. METHODS:This was a retrospective cohort study of women aged 18 years or older delivering a term neonate at an academic medical center before a...
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| Veröffentlicht in: | Obstetrics and gynecology (New York. 1953) 2019-04, Vol.133 (4), p.754-761 |
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| container_title | Obstetrics and gynecology (New York. 1953) |
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| creator | Yang, Sophia Duffy, Jennifer Y. Johnston, Robert Fall, Carolyn Fitzmaurice, Laura E. |
| description | OBJECTIVE:To evaluate the implementation of a delayed cord-clamping protocol at an academic medical center, and its short-term associations on term neonates.
METHODS:This was a retrospective cohort study of women aged 18 years or older delivering a term neonate at an academic medical center before and 5–7 months after implementation of a universal delayed cord-clamping protocol (October–December 2015 and October–December 2016, respectively). The primary outcome measure was the mean peak neonatal transcutaneous bilirubin level, with secondary outcome measures including mean initial transcutaneous bilirubin levels, mean serum bilirubin levels, number of serum bilirubin levels drawn, incidence of clinical jaundice, and phototherapy.
RESULTS:Protocol adherence was 87.8%. Data are presented on 424 neonates. The mean peak neonatal transcutaneous bilirubin levels were significantly higher among neonates in the postprotocol group (10.0±3.4 mg/dL vs 8.4±2.7 mg/dL, P |
| doi_str_mv | 10.1097/AOG.0000000000003172 |
| format | Article |
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METHODS:This was a retrospective cohort study of women aged 18 years or older delivering a term neonate at an academic medical center before and 5–7 months after implementation of a universal delayed cord-clamping protocol (October–December 2015 and October–December 2016, respectively). The primary outcome measure was the mean peak neonatal transcutaneous bilirubin level, with secondary outcome measures including mean initial transcutaneous bilirubin levels, mean serum bilirubin levels, number of serum bilirubin levels drawn, incidence of clinical jaundice, and phototherapy.
RESULTS:Protocol adherence was 87.8%. Data are presented on 424 neonates. The mean peak neonatal transcutaneous bilirubin levels were significantly higher among neonates in the postprotocol group (10.0±3.4 mg/dL vs 8.4±2.7 mg/dL, P<.01). More neonates in the postprotocol group were diagnosed with jaundice (27.2% vs 16.6%; odds ratio [OR] 1.88; 95% CI 1.17–3.01) and required serum blood draws (43.7% vs 29.4%; OR 1.86; 95% CI 1.25–2.78). However, there were no differences in mean peak serum bilirubin levels between groups (9.7±3.0 mg/dL vs 9.1±3.1 mg/dL, P=.17) or need for phototherapy (5.2% vs 6.6%, OR 1.28; 95% CI 0.57–2.89).
CONCLUSION:Implementation of a delayed cord-clamping protocol for term neonates was associated with significantly higher mean transcutaneous bilirubin levels, an increased number of serum blood draws, and more clinical diagnoses of jaundice, although there was no increase in the incidence of phototherapy.</description><identifier>ISSN: 0029-7844</identifier><identifier>EISSN: 1873-233X</identifier><identifier>DOI: 10.1097/AOG.0000000000003172</identifier><identifier>PMID: 30870273</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Academic Medical Centers ; Adolescent ; Adult ; Bilirubin - blood ; Cohort Studies ; Confidence Intervals ; Female ; Follow-Up Studies ; Humans ; Hyperbilirubinemia - epidemiology ; Hyperbilirubinemia - etiology ; Hyperbilirubinemia - physiopathology ; Infant, Newborn ; Jaundice, Neonatal - epidemiology ; Jaundice, Neonatal - etiology ; Jaundice, Neonatal - physiopathology ; Odds Ratio ; Phototherapy - methods ; Pregnancy ; Prevalence ; Retrospective Studies ; Risk Assessment ; Surgical Instruments ; Term Birth ; Time Factors ; Umbilical Cord - surgery ; Young Adult</subject><ispartof>Obstetrics and gynecology (New York. 1953), 2019-04, Vol.133 (4), p.754-761</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>2019 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4472-825d39eac126bc922f69c36fad622f7825ec113a50fb4d3bf4c87af2b171a0333</citedby><cites>FETCH-LOGICAL-c4472-825d39eac126bc922f69c36fad622f7825ec113a50fb4d3bf4c87af2b171a0333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30870273$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Sophia</creatorcontrib><creatorcontrib>Duffy, Jennifer Y.</creatorcontrib><creatorcontrib>Johnston, Robert</creatorcontrib><creatorcontrib>Fall, Carolyn</creatorcontrib><creatorcontrib>Fitzmaurice, Laura E.</creatorcontrib><title>Association of a Delayed Cord-Clamping Protocol With Hyperbilirubinemia in Term Neonates</title><title>Obstetrics and gynecology (New York. 1953)</title><addtitle>Obstet Gynecol</addtitle><description>OBJECTIVE:To evaluate the implementation of a delayed cord-clamping protocol at an academic medical center, and its short-term associations on term neonates.
METHODS:This was a retrospective cohort study of women aged 18 years or older delivering a term neonate at an academic medical center before and 5–7 months after implementation of a universal delayed cord-clamping protocol (October–December 2015 and October–December 2016, respectively). The primary outcome measure was the mean peak neonatal transcutaneous bilirubin level, with secondary outcome measures including mean initial transcutaneous bilirubin levels, mean serum bilirubin levels, number of serum bilirubin levels drawn, incidence of clinical jaundice, and phototherapy.
RESULTS:Protocol adherence was 87.8%. Data are presented on 424 neonates. The mean peak neonatal transcutaneous bilirubin levels were significantly higher among neonates in the postprotocol group (10.0±3.4 mg/dL vs 8.4±2.7 mg/dL, P<.01). More neonates in the postprotocol group were diagnosed with jaundice (27.2% vs 16.6%; odds ratio [OR] 1.88; 95% CI 1.17–3.01) and required serum blood draws (43.7% vs 29.4%; OR 1.86; 95% CI 1.25–2.78). However, there were no differences in mean peak serum bilirubin levels between groups (9.7±3.0 mg/dL vs 9.1±3.1 mg/dL, P=.17) or need for phototherapy (5.2% vs 6.6%, OR 1.28; 95% CI 0.57–2.89).
CONCLUSION:Implementation of a delayed cord-clamping protocol for term neonates was associated with significantly higher mean transcutaneous bilirubin levels, an increased number of serum blood draws, and more clinical diagnoses of jaundice, although there was no increase in the incidence of phototherapy.</description><subject>Academic Medical Centers</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Bilirubin - blood</subject><subject>Cohort Studies</subject><subject>Confidence Intervals</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hyperbilirubinemia - epidemiology</subject><subject>Hyperbilirubinemia - etiology</subject><subject>Hyperbilirubinemia - physiopathology</subject><subject>Infant, Newborn</subject><subject>Jaundice, Neonatal - epidemiology</subject><subject>Jaundice, Neonatal - etiology</subject><subject>Jaundice, Neonatal - physiopathology</subject><subject>Odds Ratio</subject><subject>Phototherapy - methods</subject><subject>Pregnancy</subject><subject>Prevalence</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Surgical Instruments</subject><subject>Term Birth</subject><subject>Time Factors</subject><subject>Umbilical Cord - surgery</subject><subject>Young Adult</subject><issn>0029-7844</issn><issn>1873-233X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1LxDAQhoMouq7-A5EcvVTztUl7XNZPEPWworeSplM3mjZr0iL7742sinjQwDAzzPPOwBuEDig5pqRQJ9Pbi2Py43Gq2AYa0VzxjHH-uIlGhLAiU7kQO2g3xucEUVnwbbTDSa4IU3yEHqcxemN1b32HfYM1PgWnV1DjmQ91NnO6XdruCd8F33vjHX6w_QJfrpYQKutsGCrbQWs1th2eQ2jxDfhO9xD30FajXYT9zzxG9-dn89lldn17cTWbXmdGCMWynE1qXoA2lMnKFIw1sjBcNrqWqVZpDIZSriekqUTNq0aYXOmGVVRRTTjnY3S03rsM_nWA2JetjQac0x34IZaMFpxKKdUkoWKNmuBjDNCUy2BbHVYlJeWHp2XytPztaZIdfl4Yqhbqb9GXiQnI18Cbdz2E-OKGNwjlArTrF__tFn9IPzDJJiRjhBZEpC5LkT73HT7Wkhc</recordid><startdate>20190401</startdate><enddate>20190401</enddate><creator>Yang, Sophia</creator><creator>Duffy, Jennifer Y.</creator><creator>Johnston, Robert</creator><creator>Fall, Carolyn</creator><creator>Fitzmaurice, Laura E.</creator><general>Lippincott Williams & Wilkins</general><general>by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20190401</creationdate><title>Association of a Delayed Cord-Clamping Protocol With Hyperbilirubinemia in Term Neonates</title><author>Yang, Sophia ; Duffy, Jennifer Y. ; Johnston, Robert ; Fall, Carolyn ; Fitzmaurice, Laura E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4472-825d39eac126bc922f69c36fad622f7825ec113a50fb4d3bf4c87af2b171a0333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Academic Medical Centers</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Bilirubin - blood</topic><topic>Cohort Studies</topic><topic>Confidence Intervals</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hyperbilirubinemia - epidemiology</topic><topic>Hyperbilirubinemia - etiology</topic><topic>Hyperbilirubinemia - physiopathology</topic><topic>Infant, Newborn</topic><topic>Jaundice, Neonatal - epidemiology</topic><topic>Jaundice, Neonatal - etiology</topic><topic>Jaundice, Neonatal - physiopathology</topic><topic>Odds Ratio</topic><topic>Phototherapy - methods</topic><topic>Pregnancy</topic><topic>Prevalence</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Surgical Instruments</topic><topic>Term Birth</topic><topic>Time Factors</topic><topic>Umbilical Cord - surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Sophia</creatorcontrib><creatorcontrib>Duffy, Jennifer Y.</creatorcontrib><creatorcontrib>Johnston, Robert</creatorcontrib><creatorcontrib>Fall, Carolyn</creatorcontrib><creatorcontrib>Fitzmaurice, Laura E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Sophia</au><au>Duffy, Jennifer Y.</au><au>Johnston, Robert</au><au>Fall, Carolyn</au><au>Fitzmaurice, Laura E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of a Delayed Cord-Clamping Protocol With Hyperbilirubinemia in Term Neonates</atitle><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle><addtitle>Obstet Gynecol</addtitle><date>2019-04-01</date><risdate>2019</risdate><volume>133</volume><issue>4</issue><spage>754</spage><epage>761</epage><pages>754-761</pages><issn>0029-7844</issn><eissn>1873-233X</eissn><abstract>OBJECTIVE:To evaluate the implementation of a delayed cord-clamping protocol at an academic medical center, and its short-term associations on term neonates.
METHODS:This was a retrospective cohort study of women aged 18 years or older delivering a term neonate at an academic medical center before and 5–7 months after implementation of a universal delayed cord-clamping protocol (October–December 2015 and October–December 2016, respectively). The primary outcome measure was the mean peak neonatal transcutaneous bilirubin level, with secondary outcome measures including mean initial transcutaneous bilirubin levels, mean serum bilirubin levels, number of serum bilirubin levels drawn, incidence of clinical jaundice, and phototherapy.
RESULTS:Protocol adherence was 87.8%. Data are presented on 424 neonates. The mean peak neonatal transcutaneous bilirubin levels were significantly higher among neonates in the postprotocol group (10.0±3.4 mg/dL vs 8.4±2.7 mg/dL, P<.01). More neonates in the postprotocol group were diagnosed with jaundice (27.2% vs 16.6%; odds ratio [OR] 1.88; 95% CI 1.17–3.01) and required serum blood draws (43.7% vs 29.4%; OR 1.86; 95% CI 1.25–2.78). However, there were no differences in mean peak serum bilirubin levels between groups (9.7±3.0 mg/dL vs 9.1±3.1 mg/dL, P=.17) or need for phototherapy (5.2% vs 6.6%, OR 1.28; 95% CI 0.57–2.89).
CONCLUSION:Implementation of a delayed cord-clamping protocol for term neonates was associated with significantly higher mean transcutaneous bilirubin levels, an increased number of serum blood draws, and more clinical diagnoses of jaundice, although there was no increase in the incidence of phototherapy.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>30870273</pmid><doi>10.1097/AOG.0000000000003172</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Obstetrics and gynecology (New York. 1953), 2019-04, Vol.133 (4), p.754-761 |
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| subjects | Academic Medical Centers Adolescent Adult Bilirubin - blood Cohort Studies Confidence Intervals Female Follow-Up Studies Humans Hyperbilirubinemia - epidemiology Hyperbilirubinemia - etiology Hyperbilirubinemia - physiopathology Infant, Newborn Jaundice, Neonatal - epidemiology Jaundice, Neonatal - etiology Jaundice, Neonatal - physiopathology Odds Ratio Phototherapy - methods Pregnancy Prevalence Retrospective Studies Risk Assessment Surgical Instruments Term Birth Time Factors Umbilical Cord - surgery Young Adult |
| title | Association of a Delayed Cord-Clamping Protocol With Hyperbilirubinemia in Term Neonates |
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