Benefits of Delayed Cord Clamping in Red Blood Cell Alloimmunization.

Abstract:

BACKGROUND AND OBJECTIVE:Several studies have shown the benefits of delayed cord clamping (DCC) in preterm and in healthy newborns at short and long term. Our objective was to evaluate the potentials benefits and risks of DCC in red cell alloimmunization. METHODS:This was a comparative before/after study of all living born neonates followed after fetal anemia requiring in utero transfusion. DCC was defined as cord clamping 30 seconds after birth. RESULTS:We included a continuous series of 72 neonates: 36 without DDC (group 1) and 36 with DDC (group 2). Hemoglobin at birth was lower in group 1 (10.2 vs 13.4 g/dL, P = .0003); 7 (25%) neonates in group 1 vs 24 (70.6%) in group 2 had no anemia at birth (P = .004). The rate of transfusion was similar between the 2 groups. Postnatal exchange transfusions were more likely performed in the group without DCC than in the group with DCC (47.2% vs 19.4%, P = .0124). Delay between birth and first transfusion was higher in group 2 (0 [0-13] vs 1 [0-21], P = .0274). The maximum level of bilirubin, the rate of intensive phototherapy, and the total duration of phototherapy were similar in the 2 groups. CONCLUSIONS:This study highlights a significant benefit of DCC in anemia secondary to red blood cell alloimmunization with a resulting decreased postnatal exchange transfusion needs, an improvement in the hemoglobin level at birth and longer delay between birth and first transfusion with no severe hyperbilirubinemia.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Garabedian C,Rakza T,Drumez E,Poleszczuk M,Ghesquiere L,Wibaut B,Depoortere MH,Vaast P,Storme L,Houfflin-Debarge V

doi

10.1542/peds.2015-3236

subject

Has Abstract

pub_date

2016-03-01 00:00:00

pages

e20153236

issue

3

eissn

0031-4005

issn

1098-4275

pii

peds.2015-3236

journal_volume

137

pub_type

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