Original ArticleDelayed vs Immediate Cord Clamping Changes Oxygen Saturation and Heart Rate Patterns in the First Minutes after Birth
Section snippets
Methods
Eligible infants were term newborn babies (≥37 weeks of gestation) born in the Maternity Ward of the University and Polytechnic Hospital La Fe (Valencia) after an uneventful pregnancy and vaginal delivery and not needing resuscitation or oxygen in the DR and whose parents approved participation. We defined birth as the expulsion of the entire fetal body. Babies <37 weeks of gestation, born by cesarean delivery, or needing any type of resuscitation maneuvers, with congenital malformations or
Results
A total of 282 infants completed between July 2018 and September 2019. The final data set included 70 257 SpO2 and 79 746 HR measurements (Figure 1; available at www.jpeds.com). Table I describes the characteristics of the infants, mothers, and delivery.
Cord clamping was delayed 110 ± 62 seconds after total fetal expulsion (Table I). We determined 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles for SpO2 and HR. Results are graphically depicted in Figures 2 and 3. Numerical values are
Discussion
We aimed to assess a normality range for SpO2 and HR using pulse oximetry in babies born at term after an uneventful pregnancy by vaginal delivery and with DCC for ≥60 seconds as presently recommended.25 HR in the first 5 minutes after birth was accurately recorded by Linde et al, with similar results using a dry electrode EKG.36 The cord was kept patent for more than 1 minute (110 ± 62 seconds) according to the 2018 guidelines of the Spanish Society of Obstetrics and Gynecology.25 Normality
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2022, Seminars in PerinatologyCitation Excerpt :However, these ranges are derived from infants receiving early cord clamping. Ongoing studies are investigating whether recommended SpO2 target ranges should be revised for term and preterm infants following DCC, with lower inspired O2 requirement (Fig. 6).36,37 During cardiac arrest, should CC be carried out with 21% or 100% O2?38
The quest for optimum oxygenation during newborn delivery room resuscitation: Is it the baby or is it us?
2022, Seminars in PerinatologyCitation Excerpt :In healthy term and near-term infants, DCC increases SpO2 and heart rate compared to immediate cord clamping.28,29 Infants with immediate cord clamping, therefore, may have impaired pulmonary transition resulting in lower HR and SpO2.28,29 An observational study of 282 healthy term newborn infants by Padilla-Sánchez et al.28 showed that DCC of ≥ 60 s was associated with increased 5 min SpO2 (median, IQR: 94, 90–96) compared to reference ranges.
C.P-S. acknowledges a grant for the development of Clinical and Care Research Projects of the Health Department Valencia-La Fe (02/2019 of May 6, 2019). A.S-G. acknowledges a predoctoral contract by the RETICS funded by the PN 2018-2021 (Spain), ISCIII- Sub-Directorate General for Research Assessment and Promotion and the European Regional Development Fund (FEDER), reference RD16/0022. M.V. acknowledges a research grant PI17/0131 from the Health Research Institute Carlos III (Ministry of Science and Innovation; Kingdom of Spain). The other authors declare no conflicts of interest.