Effect Of Time Of Cord Clamping On Serum Bilirubin Level Among Full Term Babies Born At Tikur Anbessa Specialized Hospital A Randomized Control Trial.

Background: The right timing for umbilical cord clamping has been a topic of interest for a veryrnlong time. Delayed cord clamping above one minute has linked with short and long-term nutritionalrnand developmental benefits; otherwise delaying cord clamping associated with elevated serumrnbilirubin level as potential harm that could lead to jaundice requiring phototherapy at the early agesrnof life. rnObjective: To evaluate the effect of the time of cord clamping on the serum bilirubin level andrnmeasure the serum bilirubin level difference between immediate and delayed cord clamping groupsrnwithin 24 hours of birth from October 2019 - January 2020.rnMethods: This study is ethically cleared three-arm, single blinded, randomized controlled studyrnamong healthy, full term neonates born in Tikur Anbessa Specialized Hospital, Ethiopia. A total ofrn141term babies calculated with 95% CI and 90% power as samples and enrolled in the study afterrnscreening for eligibility and have their mothers’ consent. Study participants were randomlyrnassigned across the two arms of the study; immediate cord clamping (< 1 minute and delayed cordrnclamping (1-3 minutes). The newborns are assessed for the outcomes at the age of 24rnhour andrnbefore discharge to home using bilirubinometry and Bhutan nomogram. Basic descriptive analysisrnconducted to assess the maternal social, obstetric and demographic characteristics with number andrnpercentage. Pearson Chi-square, Fisher’s exact and Kruskal Wallis tests used to compare thernassociation between maternal, fetal factors and time of cord clamping by groups. Simple and linearrnregression analysis used to predict serum bilirubin level from the predictor variables.rnResult: Maternal demographic, social and obstetrics factors were not different between the groupsrnexcept labour duration that had a P-value < 0.05. Time of cord clamping was not a significantrnpredictor of total serum bilirubin levels at the age of 24 hours rather Cord blood total serumrnbilirubin (TSB) (coef. 0.24) and bilirubin nomogram high risk zone (Coef. 6.25) were significantrnpredictors with P-value of 0.011 and < 0.001 respectively.rnConclusion: Time of umbilical cord clamping have no significant association with the total serumrnbilirubin level of neonates at least within 24 hours of birth.

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