The Journal of Maternal-Fetal & Neonatal Medicine

ISSN: 1476-7058 (Print) 1476-4954 (Online) Journal homepage: http://www.tandfonline.com/loi/ijmf20

Early versus delayed cord clamping: Effects on hematologic status

in term infants
A. Aktug Ertekin, N. Nihan Ozdemir, Zeki Sahinoglu, Tugba Gursoy, Nazan Erbil & Erdal Kaya
To cite this article: A. Aktug Ertekin, N. Nihan Ozdemir, Zeki Sahinoglu, Tugba Gursoy,
Nazan Erbil & Erdal Kaya (2015): Early versus delayed cord clamping: Effects on hematologic status in term infants, The Journal of
Maternal-Fetal & Neonatal Medicine, DOI: 10.3109/14767058.2015.1105951
To link to this article: http://dx.doi.org/10.3109/14767058.2015.1105951

Accepted author version posted online: 13 Oct 2015.

or
I.
hi

Submit your article to this journal GF

Article views: 54

Bl View related articles GF

Full Terms & Conditions of access and use can be found at
http://www.tandfonline.com/action/joumalInformation?joumalCode=ijmf20
View Crossmark data GF

Download by: [New York University]

Date: 13 November 2015, At: 12:07

Taylor &.
Francis

Downloaded by [New York University] at 12:07 13 November 2015

Taylor & Francis Group

THE JOURNAL OF

MATERNALFETAL
& NEONATAL
MEDICINE
EdHorc-nvChmf

Gian Carlo Di Renzo Dev

Maulik

Covered in
Index
Medici and
MEDUNE

Just Accepted by The Journal of Maternal-Fetal & Neonatal Medicine

Early versus delayed cord clamping: Effects on hematologic status in
term infants
A. Aktug Ertekin, N. Nihan Ozdemir, Zeki Sahinoglu, Tugba Gursoy, Nazan
Erbil, Erdal Kaya
doi: 10.3109/14767058.2015.1105951
Abstract
Objective: We investigated the effects of delayed and early clamping of the
cord on the hematologic status of the baby at birth and at the end of
second month.
Methods: Umbilical cord of 74 babies were clamped in the first 30 seconds
(Group 1) and 76 were clamped at 90-120 seconds (Group 2). Levels of
hemoglobin, hematocrit, iron and ferritin were analysed from the umbilical
cord blood at birth and from the venous samples at the end of second
month.

Results: Hemoglobin, hematocrit, iron and ferritin levels of cord blood

were similar in both groups. However, their levels other than ferritin were higher in Group 2 at the end of
second month. Two babies had respiratory distress and twelve neonates received phototherapy in Group 2
whereas only five neonates received phototherapy in Group 1.
Conclusion: Term babies to whom delayed cord clamping was performed had improved hematological
parameters at the end of second month. Therefore, delaying cord clamping in these babies may be a favorible
approach in preventing anemia.

2015 Taylor & Francis. This provisional PDF corresponds to the article as it appeared upon acceptance.
Fully formatted PDF and full text (HTML) versions will be made available soon.

DISCLAIMER: The ideas and opinions expressed in the journals Just Accepted articles do not necessarily reflect those of Taylor & Francis (the Publisher), the Editors or the
journal. The Publisher does not assume any responsibility for any injury and/or damage to persons or property arising from or related to any use of the material contained in these
articles. The reader is advised to check the appropriate medical literature and the product information currently provided by the manufacturer of each drug to be administered to verify
the dosages, the method and duration of administration, and contraindications. It is the responsibility of the treating physician or other health care professional, relying on his or her
independent experience and knowledge of the patient, to determine drug dosages and the best treatment for the patient. Just Accepted articles have undergone full scientific
review but none of the additional editorial preparation, such as copyediting, typesetting, and proofreading, as have articles published in the traditional manner. There may, therefore,
be errors in Just Accepted articles that will be corrected in the final print and final online version of the article. Any use of the Just Accepted articles is subject to the
express understanding that the papers have not yet gone through the full quality control process prior to publication.

Downloaded by [New York University] at 12:07 13 November 2015

Early versus delayed cord clamping: Effects on hematologic

status in term infants
A.Aktug Ertekin 1, Corresponding author, Department of Health
Sciences, Uskudar University, Istanbul, Turkey
GSM : +90 532

2877561 Fax :
+90

3594112
mail:

216
E-

aaertekin@gmail
.com

N.Nihan Ozdemir 2, Department of Obstetrics, Zeynep

Kamil Women and Childrens Disease, Training and
Research Hospital, Istanbul, Turkey
GSM : +90 538 6381551 E-mail :
nihanaslaner@gmail.com

Zeki Sahinoglu 2, Department of Perinatology, Clinic of

Obsterics and Gynecology, Anadolu Health Center, Kocaeli,

Turkey
GSM : +90 532 6114546
E-mail : zeki.sahinoglu@anadolusaglik.org
Tugba Gursoy 3, Department of Pediatrics, Koc University
School of Medicine, Istanbul, Turkey

GSM : +90 533 5445944 E-mail : tgursoy@ku.edu.tr

Nazan Erbil 4, Department of Pediatrics, Zeynep Kamil
Women and Childrens Disease, Training and Research
Hospital, Istanbul, Turkey GSM : +90 532 5230815 Email : erbilnazan@hotmail.com

Downloaded by [New York University] at 12:07 13 November 2015

Erdal Kaya 5, Department of Obstetrics and Gynecology,

Bagcilar Training and Research Hospital, Istanbul, Turkey

GSM : +90 536 9799494

E-mail : erdalkaya06@hotmail.com
1 Department of Health Sciences, Uskudar University, Istanbul,
Turkey
2 Department of Obstetrics, Zeynep Kamil Women and Childrens

Disease, Training and Research Hospital, Istanbul, Turkey

3 Department of Pediatrics, Women and Koc University, School
of
Medicine,
Istanbul, Childr
Turkey
4 Department of Pediatrics,
and Childrens Disease,

Hospital, Istanbul, Turkey

5 Department of Obstetrics and

Training and Research Hospital,
Istanbul, Turkey
Short title: Term babies
clamping has improved

parameters and this is a

approach in preventing
Keywords:

hemoglobin,
Abstract:

early

and

hematocrit,

Q
*

Zeynep Kamil Women

Training and Research

Gynecology,

Bagcilar

with delayed cord

hematological
favorible
anemia

delayed cord clamping,

iron, ferritin

Objective: We investigated the effects of delayed and early

clamping of the cord on the hematologic status of the baby
at birth and at the end of second month.

Methods: Umbilical cord of 74 babies were clamped in the

first 30 seconds (Group 1) and 76 were clamped at 90-120

seconds (Group 2). Levels of hemoglobin, hematocrit, iron

and ferritin were analysed from the umbilical cord blood at

birth and from the venous samples at the end of second

month.

Results: Hemoglobin, hematocrit, iron and ferritin levels of

cord blood were similar in both groups. However, their
levels other than ferritin were higher in Group 2 at the end
of second month. Two babies had respiratory distress and

twelve neonates received phototherapy in Group 2 whereas

only five neonates received phototherapy in Group 1.

Conclusion: Term babies to whom delayed cord clamping

was performed had improved hematological parameters at

the end of second month. Therefore, delaying cord

clamping in these babies may be a favorible approach in

preventing anemia.

Keywords: early and delayed cord clamping, hemoglobin,

hematocrit, iron, ferritin.
Presented in oral format at the 20

th

National Neonatalogy

Congress, April 15-18, 2012, Bodrum, Turkey.

Anemia is an important health problem all over the world,

especially in developing or low income countries among

newborn infants or children and it is also associated with

poor neurodevelopment of the infant. Iron in the blood is
essential for brain development, neurotransmitter function,

glial and neuronal energy metabolism and myelination [15]. In young children, iron deficiency anemia is associated

with behavioral and cognitive deficits, impaired motor

development

and

altered

affective

responding

[6,7].

Preventing infants and children from anemia is an

important health policy of the countries and for overcoming
this problem there is no exact consensus about early and
delayed cord clamping of the neonate or active and passive

management of the third stage of labor for preventing

postpartum anemia in women. Both managements have

advantages and disadvantages. For the mother, early cord

clamping can prevent her from anemia and shortens the

third stage of labor but there is no known favorable effect

for

the

neonate

[8].

The

main

purpose

of

active

management in the third stage of labor by administering

uterotonic drugs, early cord clamping (less then thirty

seconds or as soon as possible) and gentle traction of the

cord is to prevent postpartum hemorrhage, which may

Downloaded by [New York University] at 12:07 13 November 2015

increase maternal morbidity and mortality. Another logic of

the use of uterotonic drugs is to allow more blood

transfusion from placenta to the baby with the contractions

of the uterus [9]. In delayed cord clamping, approximately

80-100 ml of blood can be transferred to the baby which

contributes 20-30 mg/kg of iron [10,11]. In preterm

neonates, delayed cord clamping has also secondary
favorable outcomes such as reduction in the incidence of

transfusion, respiratory support, intraventricular hemorrhage

and sepsis [12,13]. There may be some adverse effects

with delayed cord clamping, which are hyperbilirubinemia,

increased

need

for

respiratory symptoms
[14-17].

phototherapy,

polycythemia

and

Downloaded by [New York University] at 12:07 13 November 2015

Methods
This prospective case-control study was conducted in
Zeynep Kamil Maternity and Childrens Disease, Training

and Research Hospital, between August 1, 2011 and

November 30, 2011. The study was approved by the local

Ethics Committee. The inclusing criteria were as follows;

neonates born to single and term pregnancies (37 to 41 +6

weeks), non-smoking and healthy mothers. The exclusion
criteria were; preterm and multiple pregnancies, operative
deliveries, neonates necessitating recussitation, presence of

fetal anomalies, intrauterine growth restriction, maternal

diseases or drug use, placental anomalies and request for
cord blood banking.

The primary outcome was to investigate the effect of early

and delayed clamping of the umbilical cord on the

hematologic status of the neonate at birth and at the end of
second month. The secondary outcomes were to analyse

effect of delayed clamping on the incidence of maternal

blood loss, neonatal respiratory distress, hyperbilirubinemia,

phototherapy need, neonatal intensive care unit (NICU)
admission and length of hospitalisation.

Informed consent was obtained from the mothers who met

the inclusion criteria and willing to participate in the study.

Mother and infant pairs were divided in 2 groups, early

(Group 1) and delayed (Group 2) cord clamping. In Group

1 cord was clamped in the first 30 seconds and in Group 2

cord was clamped 90 to 120 seconds after delivery.

Delivery of the infant shoulder was accepted as the zero

time and a staff in all births recorded the clamping time
with a stop-watch. In cesarean and vaginal births, babies

were put on a newborn table in which the level of the baby

and uterus was similiar in both groups and then the cord
was clamped early or delayed. After clamping the umbilical
cord, venous blood was obtained from the double clamped
umbilical cord of both groups for hemoglobin, hematocrit,
iron and

Downloaded by [New York University] at 12:07 13 November 2015

ferritin analyses and no blood was withdrawn from the

peripheral vein because of the study design (major

comment 2). Cord blood was collected in EDTA tubes

(BD Vacutainer, USA) for hemoglobin, hematocrit and in

serum separator tubes (BD Vacutainer tube, SST, USA) for

iron and ferritin. Blood samples were transported to the

hospital clinical chemistry laboratory where they were

analysed within 15 minutes after obtaining the samples. In

our clinic, during the third period of delivery, we did not
use any uterotonic drugs before the expulsion of placenta

(minor comment 1). All newborns were examined by a

pediatrician in the first 24 hours and early breastfeeding

was encouraged. As a general rule mothers giving birth via

vaginal deliveries were discharged after 24 to 72 hours and

mothers giving birth via cesarean section were discharged

24 to 96 hours after puerperal education and drug

prescription. At the end of second month, the same

hematologic parameters were analysed from the venous

blood with the same method in both groups.

Statistical Package for the Social Sciences for Windows,

16.0 version was used for the statistical analyses. Students

t test and X were used for comparison of two groups and

for statistical significance, type I error was calculated as

5%.

Downloaded by [New York University] at 12:07 13 November 2015

Results
The demographic characteristics of the mother-infant pairs
and hematological parameters of the mothers did not differ

between the groups (Table 1). However, delivery by

cesareanne section was significantly higher in Group 1. In

Group 1 and Group 2 average cord clamping times were
20,5 and 101,1 seconds, respectively (major comment 1).
Hematological parameters of the cord blood and at the age

of 2 months of the infants in both groups are given in

Table 2. Though cord blood hemoglobin hematocrit and
iron levels did not differ between the groups, they were

significantly higher in infants whose cord were clamped

late at the age of 2 months (Table 2). However, ferritin

levels of both groups did not differ neither in cord blood

samples nor in blood samples obtained at two months of
age.

Table I
Table II
Five infants (6,8%) in Group 1 and 12 (15,7%) infants
in Group 2 needed phototherapy (p=0.08). Mean of

maximum bilirubin level observed was 17.6 1.8 g/dL

in Group 1 and 17.9 2.1 g/dL in Group 2 (p=0.7)
(major comment 3). Only the neonates who received

phototherapy were subjected to blood withdrawal of about

2 ml for direct and indirect bilirubin, blood type and

direct coombs test (major comment 5). Two of the babies

in Group 2 had mild tachypnea that lasted less than two
hours, however, there was no NICU admission in both
groups. None of the infants had polycythemia. No

postpartum hemorrhage was observed in either group. No

babies received iron therapy. All the babies were

exclusively breastfed and received 400 IU vitamin D

starting from the first week of life up (major comment 4).

No baby had an infectious event during follow up (major
comment 6).

Discus
sion
World
Health Organisation advises late cord clamping;
however there is a debate on the optimal time for cord
clamping [18]. If the cord clamping is deferred more than

60 seconds, blood flow between the baby and placenta

continues and is usually completed by 120 seconds and

named as placental transfusion. This allows the transfusion
of 80-100 ml of blood which constitutes about one third or

a quarter of the newborns total blood volume [10]. Even

though not fully clear, placental transfusion could be
considered as a cause of some undesirable effects in the

newborn and as well as in the mother such as polycytemia,

jaundice, respiratory symptoms, phototherapy need and

postpartum uterine hemorrhage. In this study, although the

incidence of jaundice necessitating phototherapy was higher

in infants whose cords were clamped late, this difference

did not reach statistical significance (6,8% vs 15,7%;

p=0,08) as confirmed in the literature [19-22]. As

mentioned in the material- methods, we paid attention to

put all the neonates on a newborn table which was

approximately at the same level with the uterus to facilitate

blood transmission from the placenta to the newborn.

However, in a multicenter trial at three university-affiliated

Downloaded by [New York University] at 12:07 13 November 2015

Discus
sion
hospitals
in Argentina, the autors mentioned that position of
the newborn baby before cord clamping does not seem to

affect volume of placental transfusion. Therefore, mothers

could safely be allowed to hold their baby on their

abdomen or chest. This change in practice might increase

obstetric compliance with the procedure, enhance maternalinfant bonding and decrease iron deficiency in infancy [23].

We found that delaying cord clamping up to 90 to 120

seconds increases hemoglobin, hematocrit and iron levels

significantly at the second month. Although there was no

difference of iron levels between early and delayed cord

clamping groups at birth, a significantly higher iron level

was achieved at the second month of age in the delayed

clamped group. An increase of serum iron level rather than

hemoglobin, allows more tissue

Downloaded by [New York University] at 12:07 13 November 2015

oxygenation, proper myelinization, improved hematologic

parameters and less ventilator support [24,25]. Iron is an

essential trophic factor that is required for oxygen

consumption and ATP production. The brain has a

relatively high rate of oxygen consumption compared to

other organs. Oligodendrocytes are the principal cells in the

central nervous system that stain for iron under normal

conditions. The timing of iron delivery to oligodendrocytes
during myelinization is essential because hypomyelination
and the associated neurological sequelae persist long after
the systemic iron deficiency has been corrected. Due to the

hypomyelination, most common neurological signs of iron

deficiency in children include poor school performance,

decreased cognitive abilities and behavior problems [26].

Furthermore, these neurological sequelae persist even after
iron supplementation.

While prominent positive effects of delayed cord clamping

on hemoglobin, hematocrit and serum iron levels were well
established, clamping cord after the first breath of the
neonate was shown to have improving effect on neonatal

cardiac and pulmonary functions [9]. In a study including

of 15.563 newborns outcomes in a rural hospital, the risk

of death/NICU admission was consistently higher if cord

clamping occurred before spontaneous respiration [27].

While infants of birth weight <2500 g were more likely to

die or be admitted at NICU, the risk of death or NICU
admission decreased by 20% for every 10-second delay in

cord clamping after spontaneous respiration. The authors

concluded that healthy self-breathing neonates were more

likely to die or be admitted if cord clamping occured
before

or

respiration.

experimental

demonstrating

immediately

These

after

clinical

findings

smoother

of

onset

of

observations

an

animal

cardiovascular

spontaneous

support

based

transition

the

study

delayed cord clamping after initiation of ventilation [9].

with

It was known that umbilical cord blood contains various

valuable stem cells such as haematopoietic stem cells,

endothelial cell precursors, mesenchymal progenitors and
multipotent/pluripotent

lineage

preventing anemia in newborns by

stem

cells.

Besides

Downloaded by [New York University] at 12:07 13 November 2015

delayed cord clamping, the merit of delayed cord clamping

has been magnified by realizing first stem cell transfer. In

view of this purpose, not only in preterm births, delayed

cord clamping should be encouraged in term births too

[28].

We conclude that delayed cord clamping in term babies

had no effect on hematologic status at birth but had

improving effects on hemoglobin, hematocrit and iron levels

at the second month without any serious complication.
However, phototherapy need may be increased in delayed
group.

Delayed cord clamping could be considered an appropriate

and easy to perform approach in increasing iron levels,

circulating blood volume and stem cells which seem to be

key factors in myelinization and smooth passage to

extrauterine circulation in term neonates. Long term follow
up studies should be performed to evaluate the effects of

higher iron levels on the neurocognitive outcome of the

babies.

Acknowledgements
The authors report no acknowledgements.
Declaration of interest
The authors report no declarations of interest

Downloaded by [New York University] at 12:07 13 November 2015

References
1. Lozoff B, Brittenham GM, Wolf AW, McClish DK, Kuhnert
PM, Jimenez E, Jimenez R, Mora LA, Gomez I, Krauskoph
D. Iron deficiency anemia and iron therapy effects on infant

developmental test performance. Pediatrics 1987;79:981-95.

2. Lozoff B, Beard J, Connor J, Barbara F, Georgieff M,

Schallert T. Long-lasting neural and behavioral effects of

iron deficiency in infancy. Nutr Rev 2006;64(5 Pt 2): S34S91.

3. Beard J. Recent evidence from human and animal studies

regarding iron status and infant development. J Nutr
2007;137:524- 30S.

4. McCann JC, Ames BN. An overview of evidence for a

causal relation between iron deficiency during development

and deficits in cognitive or behavioral function. Am J Clin
Nutr 2007;85:931-45.

5. Carlson ES, Tkac I, Magid R, OConnor MB, Andrews NC,

Schallert T, Gunshin H, Georgieff MK, Petryk A. Iron is

essential for neuron development and memory function in

Mouse hippocampus. J Nutr 2009;139:672-8.

6. Nelle M, Zilow EP, Kraus M, Bastert G, Linderkamp O.

The effect of Leboyer delivery on blood viscosity and other

hemorheologic parameters in term neonates. Am J Obstet
Gynecol 1993;169:189-93.

7. Gunnarsson BS, Thorsdottir I, Palsson G, Gretarsson SJ. Iron

status at 1 and 6 years versus developmental scores at 6

years in a well-nourished affluent population. Acta Paediatr

2007;96:391-5.

8. Rogers J, Wood J, McClandish R, Ayers S, Truesdale A,

Elbourne D. Active versus expectant management of third

stage of labour: the Hinchingbrooke randomised controlled

trial. Lancet 1998;351 (9104): 693-9.

Downloaded by [New York University] at 12:07 13 November 2015

9. Duley L, Batey N. Optimal timing of umbilical cord

clamping for term and preterm babies. Early Human
Development 2013;89:905-908.

10.

Farrar D, Airey R, Law G, Tuffnell D, Cattle B,

Duley L. Measuring placental transfusion for term births:

weighing babies with cord intact. BJOG 2011;118:70-5.

11.

McDonald SJ, Middleton P, Dowswell T, Morris PS.

Effect of timing of umbilical cord clamping of term infants

on maternal and neonatal outcomes. Cochrane Database
Syst Rev 2013;7: CD004074.

12.

Mercer J, Vohr B, McGrath M, Padbury J, Wallach

M, Oh W. Delayed cord clamping in very preterm infants

reduces the incidence of intraventricular hemorrhage and

late- onset sepsis: a randomized, controlled trial. Pediatrics

2006;117:1235-42.

13.

Oh W, Fanaroff A, Carlo W, Donovan E, McDonald

S, Poole W. Effects of delayed cord clamping in very-lowbirth-weight infants. J Perinatol 2011;31:S68-71.

14.

in

Yao AC, Lind J, Vuorenkoski V. Expiratory grunting

the

late

1971;48:865-70.
15.

clamped

normal

neonate.

Pediatrics

Saigal S, Usher RH. Symptomatic neonatal plethora.

Biol Neonate 1977;32:62-72.

16.

Van Rheenen P, Brabin BJ. Late umbilical cord-

clamping as an intervention for reducing iron deficiency

anaemia in term infants in developing and industrialised
countries:

2004;24:3-16.

17.

Wang

systematic

review.

Ann

CL, Anderson C, Leone

Trop

TA,

Paediatr

Rich

W,

Govindaswami B, Finer NN. Resuscitation of preterm

neonates by using room air or 100% oxygen. Pediatrics
2008;121:1083-9.

18.

World Health Organization. Care in normal birth: A

practical

guide.

Switzerland:

WHO

Safe

Motherhood

Technical Working Group: Geneva 1996;p. 32-3.

19.

Oxford Midwives Research Group. A study of the

relationship between the delivery to cord clamping interval

and the time of cord separation. Midwifery 1991;7: 16776.

Downloaded by [New York University] at 12:07 13 November 2015

20.

Emhamed MO, van Rheenen P, Brabin BJ. The early

effects of delayed cord clamping in term infants born to

Libyan mothers. Trop Doct 2004;34: 218-22.

21.

Chaparro CM, Neufeld LM, Alavez GT, Cedillo REL,

Dewey KG. Effect of timing of umbilical cord clamping on

iron status in Mexican infants: a randomised controlled trial.

Lancet 2006;367: 1997-2004.

22.

Andersson O, Hellstrom-Westas L, Domellof M.

Effect of delayed versus early umbilical cord clamping on

neonatal outcomes and iron status at 4 months: a randomised

controlled trial. BMJ 2011;343: d7157 doi: 10.1136/bmj,
d7157 .

23. Vain NE, Satragno DS, Gorenstein AN, Gordillo JE,

Berazategui JP, Alda MG,

Prudent LM. Effect of gravity on volume of placental

transfusion: A multicentre, randomised, non-inferiority trial.

Lancet 2014;384
24.

10.1016/S0140-6736(14)60197-5.

(9939):235-40. doi:

Hosono S, Mugishima H, Fujita H, Hosono A, Minato

M, Okada T, Takahashi S, Harada K. Umbilical cord

milking reduces the need for red cell transfusions and

improves neonatal adaptation in infants born at less than 29

weeks gestation: a randomized control trial. Arch Dis Child

Fetal Neonatal Ed 2008;93:F14-F19.

25.

Krueger MS, Eyal FG, Peevy KJ, Hamm CR,

Whitehurst RM, Lewis DF. Delayed cord clamping with and

without cord stripping: A prospective randomized trial of

preterm neonates. Am J Obstet Gynecol 2015; 212:394 e1394e5.

26.

Oski FA, Honig AS, Helu B, Howanitz P. Effect of

iron therapy on behavior performance in nonanemic, irondeficient infants. Pediatrics 1983;71(6):877-80.

27.

Ersdal HL, Linde J, Mduma E, Auestad B, Perlman J.

Neonatal outcome following cord clamping after onset of

spontaneous respiration. Pediatrics 2014;134(2):265-72.

28.

Tolosa JN, Park DH, Eve DJ, Klasko SK, Borlongan

CV, Sanberg PR. Mankind's first natural stem cell transplant.

J Cell Mol Med 2010;14(3):488-95.

Downloaded by [New York University] at 12:07 13 November 2015

Tables
Table I. The demographic characteristics and hematological
parameters in both groups.
Group 1 n: Group 2 n:76
74
26,55,2
2 (1-3)

Age (mean SD)

Gravida
Cord clamping
20,5+6
time
(seconds, mean
SD)
Maternal Hb, g/dl 13,111,7
(mean SD)

Maternal Hct, %
34,73
(mean
SD)
Maximum
17.6 1.8
bilirubin
level (g/dL, mean

SD)
Delivery route,
71 (95,9)
vaginal
birth, n (%)
Birth weight (g)
3357329
Gestational age
38,9 0,9
(weeks)
5th minute Apgar
9 (9-9)
score

26,95,4
2 (1-3)

0,66
0,1

101,1+8,3

<0,001

11,61,4

0,48

34,64

0,86

17.9 2.1

0.7

53 (69,7)

<0,001

3268383

0,13

/V

39,1 1,1
9 (9-9)

0,23
0,58

Downloaded by [New York University] at 12:07 13 November 2015

Table II. Hematological parameters of cord blood and at the

age of 2 months of the infants in both groups.
Cord blood levels

Second month blood

Group 1 Group 2 p
Hb,
g/dl,
(mean
SD)
Hct,
%,
(mean

15,41 15,21,8 0,5

,5
3

9,90,9

10,30,
8

0,0
03

45,74 46,16
,6

292,2

30,32,
5

0,00
1

0,0 68,525,3 79,625

53
,5

0,00
8

SD)
Fe,
161,2 14650
mcg/dl, 45,9
(mean
SD)
Ferriti
n,

0,6
2

2222 171,91 0,0

00
14,8
58
levels
ng/ml (mean SD)
p< 0.05: statistically significant

240,314 231,11
7,7
23

0,
68