A
Quantitative Study: Delayed Cord Clamping on Sickle Cell Anemia Mothers and the
Impact on the Full-Term Newborn Hemodynamics
BACKGROUND
Delayed cord clamping (DCC) results in increased
blood supply from the placenta to the neonate.
However, hemodynamics and overall general
health in neonates from maternal sickle cell
patients has not yet been researched.
There is a strong relationship between maternal
anemia and newborn anemia. Overall, there was a
61.1% prevalence of low hemoglobin levels in
newborns that were born to women that had
anemia at the time of delivery. Other factors such
as the presence of malaria, polygamous families,
and infant nutrition levels had an effect on infant
hemoglobin levels.
DCC provides the newborn with an additional 40%
more blood volume by allowing more time to
transfer blood and nutrients from the placenta to
the neonate (Ashish et al.,2016).
DCC in full term newborns has resulted in reduced
prevalence of neonatal anemia, increased level of
hemoglobin, hematocrit, improved iron status
deficiency at 6 months in infants.
SAMPLE POPULATION
Inclusion Criteria:
a) singleton pregnancy
b) childbearing age up to 34 years old
c) term gestation >37 weeks
d) vaginal delivery
e) healthy pregnancy with no other complications
Exclusion Criteria:
a) advanced maternal age
b) previous cesarean section
c) gestational diabetes
d) other types of blood disorders
N. Rosas, K. Salas, T. Simbra, M. Spring
STUDY QUESTIONS ANTICIPATED RESULTS
Our group hypothesizes that delayed cord clamping in maternal sickle cell patient for full We anticipate that the results will show an increase
term babies, will have a beneficial increase on the infants hemoglobin, hematocrit, ferritin, in iron stores for the neonate.
and bilirubin levels at birth, 24 hours and 3 days of life. Future research results will show an increase in
In addition to this, our group also hypothesizes that delayed cord clamping in maternal general health status versus immediate cord
sickle cell patient for full term babies will have an overall beneficial effect on the clamping.
neurological, respiratory, and cardiac function of the newborn. There will be a decrease in number of sickle cell
crises.
METHODS
Upon admission to the labor and delivery unit, the attending physician will open a
concealed envelope that will show the treatment allocation with 1:1 randomization.
The interventional group will receive DCC of 3 minutes.
The control group will not receive DCC.
Training videos will be provided to the physician and nurses for proper procedure
guidelines prior to the study beginning.
Time of delivery to cord clamping will be estimated by a stopwatch help by a delivery room
IMPLICATIONS FOR NURSING
nurse assistant or registered nurse.
After 3 minutes the cord is clamped.
During the 3 minutes, should the newborn show any signs of compromise, the cord will The future implications of this study are to improve
immediately be cut and the newborn will be resuscitated according to NRP guidelines. neonatal hemodynamic levels and infant health
status by increasing the general quality of life of
newborns.
DATA ANALYSIS A healthier population of newborns and future
generations are on the horizon.
To perform this randomize interventional quantitative study the following hemodynamic If there are successful findings from this study The
levels will be measured: maternal hemoglobin and neonatal hemoglobin, hematocrit, ferritin, American Academy of Pediatrics can come to
and bilirubin at birth, 24 hours and 3 days of life and effects on long term overall general conclusive evidence that would support delayed
health. cord clamping in high risk pregnancy- particularly
Group means will be compared by using the t-H&H significance difference test. All results maternal sickle cell patients.
will be based on two-tailed tests and P value of < 0.05 will be used as the criterion for
significance.
FUTURE RESEARCH
ACKNOWLEDGEMENTS
DCC on full term neonates
Professor Ana-Marie Gallo Ana-Maria Gallo PhD, CNS, RNC Other delivery methods for vulnerable populations
DCC on high risk pregnancies
APU GNRS 508A- Research and Theory in Advanced Nursing Practice
Future general health status on DCC newborns
National Association of Neonatal Nurses-Smart Brief Statistics on sickle cell crises admissions