Effects of Timing of Umbilical Cord Clamping on Serum Calcium Levels in Neonates- A Randomized Controlled Trial

Abstract

Objective: To assess the impact of the timing of umbilical cord clamping on serum calcium levels in neonates.

Study Design:  Prospective, randomized control trial

Place & Duration of Study: Pak Emirates Military Hospital, Rawalpindi from January 2024 to December 2024

Methodology: 160 neonates were selected through computer-generated randomization and allocated randomly to four groups (n=40 each). The study included full-term pregnant women with no comorbidities. Mothers with gestational diabetes, hypertension, or any other pregnancy-related complications were excluded. Neonates with congenital anomalies or birth complications were also excluded. After delivery, the neonates' umbilical cords were clamped according to their respective group timing. At six hours of life, venous blood samples were drawn from the neonates to assess serum calcium levels and other lab parameters.

 Results:  One hundred sixty babies (n=160) included 73 (45.63%) females and 87 (54.37%) males. The mean gestational age was 38.10 (± 0.99) weeks. A gradual increase in serum total and ionized calcium levels was observed. The serum total and ionized calcium levels were 2.12 (±0.12) mmol/L and 1.10 (±0.09) mmol/L, respectively, at 15 seconds (Group-1) of cord clamping and were 2.30 (±0.16) mmol/L and 1.22 (±0.06) mmol/L at 120 seconds (Group-4). Total serum calcium levels at 15 and 30 seconds (s) were significantly lower (p<0.001) than those at 120 s. A similar trend was seen for serum ionized calcium levels (p<0.001).

Conclusion: Delayed cord clamping significantly improves total and ionized serum calcium levels in neonates, ameliorating neonatal health and neuromuscular stability.