Impact of Early Versus Delayed Cord Clamping on Oxygen Saturation of Newborn

Abstract

Background: Delayed umbilical cord clamping (DCC) is increasingly recognized for its role in enhancing neonatal transition and oxygenation, yet early cord clamping (ECC) remains common in many clinical settings, particularly where standardized protocols are lacking. Despite strong physiological rationale, local evidence remains scarce regarding the immediate effects of clamping time on oxygen saturation in term newborns. Objective: This study aimed to compare the effects of ECC and DCC on oxygen saturation (SpO₂) trends in full-term neonates during the first ten minutes of life, evaluating whether DCC provides a superior cardiopulmonary adaptation advantage. Methods: A randomized controlled trial was conducted at Mayo Hospital, Lahore, involving 200 term neonates randomized equally to ECC (≤30 seconds) or DCC (60–120 seconds). Inclusion criteria included gestational age of 37–42 weeks with exclusion of congenital anomalies or resuscitation need. Pre-ductal SpO₂ was measured at 1, 5, and 10 minutes post-birth using pulse oximetry. Ethical approval was granted per the Helsinki Declaration. Data were analyzed using SPSS version 25 with independent t-tests and repeated measures ANOVA. Results: At 1 minute, mean SpO₂ was higher in DCC (82.06%, 95% CI 81.25–82.87) than ECC (78.04%, 95% CI 77.16–78.92; p<0.0001), with significant differences persisting at 5 minutes (DCC 91.92% vs ECC 89.09%) and 10 minutes (DCC 96.09% vs ECC 94.06%), all p<0.0001. Conclusion: DCC significantly improves neonatal oxygen saturation in the first critical minutes of life, reinforcing its clinical value as a low-cost, effective strategy to support perinatal respiratory adaptation.