Effect of cord clamping duration on cord blood gas and apgar score in term newborn babies born by cesarean section

This study aimed to determine the effects of early and delayed umbilical cord clamping practices in term neonates on cord blood gas parameters, 1st and 5th-minute APGAR scores, and the length of neonatal intensive care unit (NICU) stay. A total of 100 term pregnancies without any medical complications underwent cesarean delivery. The cases were divided into two groups. In the first group, consisting of 50 neonates, the umbilical cord was clamped within the first 30 seconds after birth, serving as the control group. In the second group, comprising 50 neonates, the umbilical cord was clamped 60 seconds after birth, and this group was considered the intervention group. During the waiting period, the neonate was kept at the same level as the uterus, positioned on the mother's abdomen. The study collected and compared data on maternal age, diagnosis, gravida, parity, number of abortions, gestational week, indication for cesarean section, fetal birth weight, neonatal length and head circumference, cord blood pH, partial oxygen pressure (pO2), partial carbon dioxide pressure (pCO2), bicarbonate (HCO3), base excess (BE), lactate, hemoglobin (Hb), bilirubin levels, and 1st and 5th-minute APGAR scores, as well as NICU length of stay between the control and intervention groups. In the control group (early clamping), the mean cord blood gas values were as follows: pH 7.33±0.04, pCO2 43.26±6.50 mmHg, pO2 35.85±12.9 mmHg, BE -3.7±2.09 mmol/L, lactate 1.91±1.89 mmol/L, HCO3 23.06±1.99 mmol/L, Hb 14.9±1.64 g/dL, and bilirubin 1.00±1.00 mg/dL. The 1st and 5th-minute APGAR scores were 6.14±1.30 and 8.12±1.08, respectively, with an average NICU stay of 0.24±1.20 days. In the intervention group (delayed clamping), the mean cord blood gas values were: pH 7.33±0.03, pCO2 45.13±5.70 mmHg, pO2 32.77±10.9 mmHg, BE -2.39±1.87 mmol/L, lactate 1.89±0.61 mmol/L, HCO3 23.04±1.85 mmol/L, Hb 15.6±1.83 g/dL, and bilirubin 1.77±1.46 mg/dL. The 1st and 5th-minute APGAR scores were 6.16±1.36 and 8.08±1.20, with an average NICU stay of 0.22±0.73 days. No statistically significant differences were found between the control (early clamping) and intervention (delayed clamping) groups regarding cord blood gas parameters (pH, pO2, pCO2, HCO3, lactate, Hb), 1st and 5th-minute APGAR scores, or NICU stay duration (p>0.05). However, BE levels were significantly lower in the control group (p=0.001), and bilirubin levels were significantly higher in the intervention group (p=0.003).