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Sabeen Shahid, Sidra Aslam, Tehreem Rubab


Anemia is common disorder in pediatric population. In developing countries, prevalence of iron deficiency anemia (IDA) is highest among children aged below five years. In Pakistan, overall 62.3% children are anemic out of which 4.1% are severely anemic. IDA is associated with impaired physical growth and cognitive development in children less than five years of age. Objective: To compare the mean hemoglobin levels and frequency of polycythemia in full term neonates after early and delayed cord clamping Study Design: Randomized Controlled Trial The sample size was calculated by the WHO sample size calculator, with consecutive non probability Sample size = 95 in each group, total sample size = 190, using power of test 80% ,level of significance 5% ,anticipated population proportion 1=5%, Anticipated population proportion 2=16%. Setting: The study was conducted in DHQ Hospital, Faisalabad Duration Of Study: Six month from the date of approval of synopsis from board of study (December 2018 to June 2019) Methodology: One hundred and ninety full term neonates were selected after fulfilling inclusion and exclusion criteria. All the participants were divided into two equal groups randomly. One group was subjected to early cord clamping after delivery while other group was subjected to late cord clamping. Two hours after clamping the venous blood samples were taken for the hemoglobin and hematocrit levels. SPSS version 17 for windows was used for statistical analysis. Mean and standard deviation were calculated for gestational age, birth weight, hemoglobin and hematocrit. Frequency and proportions were calculated for gender and polycythemia. Effect modifiers like gestational age, gender and birth weight were controlled by stratification. Independent sample t test and Chi square tests were applied before and after stratification appropriately. A p value of ≤ 0.05 was considered significant. Results: Mean gestational age of the mothers was 39.27 ± 1.50 weeks (mean ±SD). Out of 190 neonates, 91 (47.9%) were males while the 99 (52.1%) were females. The mean birth weight was 3.64 ± 0.72 kg (mean ± SD) while mean Hb and HCT levels were 16.07 ± 2.30 g/dl and 63.26 ± 5.32% respectively.Keeping cut off value of 13.5 g/dl of Hb to label anemia or no, my study showed that 35 (18.4%) neonates were anemic. The polycythemia (HCT >65%) was present in 72 (37.9%) of neonates. There was no difference between groups in terms of gender, anemia, gestational age and birth weight (p values 0.663, 0.852, 0.700 and 0.491 respectively). The distribution of polycythemia was different among groups (p value 0.007). The mean hemoglobin level in group A was 15.52 ± 1.90 g/dl while in group B it was 16.62 ± 2.53 g/dl (p value 0.001). Similarly, the mean hematocrit level was different among groups (62.09 ± 4.75 and 64.43 ± 5.62 for group A and B respectively, p value 0.002). The stratification results showed the results showed that mean Hb levels are statistically not different among some of the groups (gestational age <40 weeks, birth weight <4 kg) while HCT levels are significantly different among male group and category of birth weight >4 kg.Rest of the stratification groups showed significant difference. CONCLUSION: The delayed cord clamping in neonates results in increased mean hemoglobin and hematocrit levels with increased frequency of polycythemia as compared to early cord clamping. KEYWORDS: Infant, Newborn, Hemoglobins, Umbilical Cord, Polycythemia, Prognosis,


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