Tempo ideal do clampeamento do cordão umbilical para o recém-nascido: um ensaio clínico randomizado controlado

Abstract

Late clamping of the umbilical cord at birth is considered one of the good obstetric and neonatal care practices during childbirth. Studies point to the benefits in relation to the non-development of anemia by the newborn, although in clinical practice some professionals report the increase of newborns requiring phototherapy intervention. This study aimed to determine the optimal time for clamping the umbilical cord in order to reduce risks for the newborn in relation to jaundice. This is a randomized controlled trial, with four groups, two controls, the first and third minutes; and two experimental, the fourth and fifth minutes. 88 NBs were evaluated from January 2018 to July 2018. In this sense, clinical data were collected from the newborn at birth and after 72 hours of life, and from the mother, before and after delivery. The four groups of newborns submitted to different clamping times had no significant statistical difference in bilirubin values requiring phototherapy intervention for these newborns (p = 0.43). The analysis showed that the mean total bilirubin in the fourth minute was the highest: 8.98 (± 5.22) versus the first minute bilirubin that had the lowest mean: 7.21 (± 4.37). The jaundice zone showed a positive and significant correlation (r = 0.272, p = 0.01), and as the clamping time increased, more regions of the NB body presented yellow pigmentation. The jaundice zone presented statistically significant difference (p = 0.01) with diastolic blood pressure (DBP). Women, whose NB progressed with jaundice in zone 4, had a mean PAD of 85.5 (± 20.6), higher than the other jaundice zones. The time of 1 and 3 minutes seems to be the ideal time for clamping of the umbilical cord, by the evaluations carried out in this study. Further studies are expected to take into account, as a parameter, blood volume, not just time.