Effect of umbilical cord clamping time on hemoglobin status of infants, randomized control trial in Longisa County Referral Hospital, Bomet County, Kenya.

Abstract

Background: Although the benefits of delayed Umbilical Cord Clamping on haemoglobin are documented globally, including by the World Health Organization (WHO), Kenya and many Sub-Saharan African Countries continue to record variation in the Clamping time. These variations may have a significant effect on the iron levels and the nutritional status of the infant.

Objective: This study sought to establish the effects of umbilical cord clamping time, iron and possibly the infant nutritional status at six months at Longisa County Referral Hospital.

Methods: The study was a randomized controlled trial design. Mother-infant pairs were randomized into the experimental and control groups. A sample size of 204 mother-infant pairs was enrolled in both arms of the study. The recruitment of study participants took place at the onset of labour for all eligible mothers admitted to the labour and delivery ward. The experimental group involved clamping the umbilical cord between three five minutes after delivery, while the control group involved clamping of the umbilical cord as per the standard routine practice after delivery in the health facility. Infant weight, Length and haemoglobin were assessed at baseline, at six weeks and at six (6) months. Data was collected using a structured questionnaire. Data was analyzed using Stata Statistical software and Microsoft Excel. Comparison of the effect of umbilical cord clamping time on Length, height, and haemoglobin at six weeks and six months was performed using an unpaired t-test with 95% CI, significance set at p<0.05. Two-sample t-test, the results for weight, Length and hemoglobin was determined. Research permits and ethical approval were obtained from the respective authorities.

Results: The mean weight at six months of life for the control group of the study was 7.41 ± 0.65 kg, while for the experimental group, the mean weight was 8.51 ± 0.60 kg. The mean Length at six months for the control group was 56.91 ± 14.36cm, and the experiment group was 58.18 ± 16.72cm. The mean haemoglobin levels for the control group were 11.35 (11.08-11.62), and for the experimental group, 12.22 (11.95-12.49).

Conclusion: Delayed umbilical cord clamping is beneficial for improving infant hemoglobin levels and possibly nutrition status. In addition, delayed umbilical cord clamping time improves the infant's weight gain in the first six months of life. There is a need to develop guidelines for the implementation of delayed umbilical cord clamping. The recommendation for further research is to study child survival and long-term health and cognitive effects of nutrition and care during the first 1,000 days.