DELAYED CLAMPING OF THE UMBILICAL-CORD IMPROVES HEMATOLOGIC STATUS OFGUATEMALAN INFANTS AT 2 MO OF AGE

Iron deficiency anemia is a serious health problem that affects the ph ysical and cognitive development of children. Therefore, it is importa nt to develop cost-effective interventions to improve the hematologic status of the millions of children affected by this condition worldwid e. We studied 69 Guatemalan infants who had been randomly assigned to one of three groups at the time of delivery: 1) cord clamping immediat ely after delivery (n = 21); 2) clamping when the cord stopped pulsati ng, with the infant placed at the level of the placenta (n = 26); or 3 ) clamping when the cord stopped pulsating, with the newborn placed be low the level of the placenta (n = 22). Maternal and infant hematologi c assessments were performed at the time of delivery and 2 mo postpart um. At baseline the groups had similar socioeconomic, demographic, and biomedical characteristics and the newborns had similar hematocrit st atus. Two months after delivery, infants in the two groups with delaye d cord clamping had significantly higher hematocrit values and hemoglo bin concentrations than did those in the early-clamping group. The per centage with hematocrit values < 0.33 was 88% in the control group com pared with 42% in group 2 and 55% in group 3 (P = 0.01). These results suggest that waiting until the umbilical cord stops pulsating (approx imate to 1 min after delivery) is a feasible low-cost intervention tha t can reduce anemia in infants in developing countries.