Delayed umbilical cord clamping hypothesized to boost infant hemoglobin and ferritin at three months

Iron deficiency anemia affects up to 50% of children by 12 months in developing countries like Pakistan, a major risk factor for neonatal and infantile mortality and morbidity. It causes irreversible neurodevelopmental damage. Cost-effective perinatal interventions are limited. Delayed cord clamping is thought to prevent anemia by increasing iron stores, but its global adoption faces controversy and a lack of national guidelines/data, especially in Pakistan. This study aims to fill that gap by developing a cost-effective protocol.

This will be a randomized controlled trial conducted in Pakistan. The study will compare delayed cord clamping to early cord clamping. Primary objectives include assessing infant hemoglobin (Hb), hematocrit (Hct) at birth and 48 hours, and Hb, Hct, and ferritin at three months of age. Short-term clinical outcomes like jaundice, respiratory distress, anemia, and polycythemia in neonates (first 24 to 48 hours of life) will also be studied. Maternal outcomes, followed till 48 hours postpartum, will be a secondary objective.