Debra Erickson-Owens - Academia.edu (original) (raw)
Papers by Debra Erickson-Owens
Journal of Perinatology, 2016
Objective-To measure the effects of a five-minute delay (DCC) versus immediate cord clamping (ICC... more Objective-To measure the effects of a five-minute delay (DCC) versus immediate cord clamping (ICC) on residual placental blood volume (RPBV) at birth, and hemoglobin and serum bilirubin at 24 to 48 hours of age. Study Design-In this prospective randomized controlled trial, seventy-three women with term (37 to 41 weeks) singleton fetuses were randomized to DCC (≥5 minutes; n=37) or ICC (<20 seconds; n=36). Results-Maternal and infant demographics were not different between groups. Mean cord clamping time was 303 ± 121 (DCC) versus 23 ± 59 (ICC) seconds (p<0.001) with 10 protocol violations. Cord milking was the proxy for DCC (n = 11) when the provider could not wait. Infants randomized to DCC compared to ICC had significantly less RPBV (20.0 vs 30.8 mL/kg, p<0.001), higher hemoglobin levels (19.4 vs 17.8 g/dL, p=0.002) at 24 to 48 hours, with no difference in bilirubin levels. Conclusions-Term infants had early hematological advantage of DCC without increases in hyperbilirubinemia or symptomatic polycythemia. Keywords delayed cord clamping; umbilical cord milking; hemoglobin; bilirubin; residual placental blood volume; placental transfusion Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:
Quality Nursing, Aug 1, 2002
American Journal of Perinatology, Mar 2, 2020
Objective The aim of this study was to estimate the incidence and identify the factors associated... more Objective The aim of this study was to estimate the incidence and identify the factors associated with neonatal readmission among healthy term infants. Study Design A nested case–control study with matching was conducted at a large level III perinatal hospital with approximately 8,700 deliveries each year. Each case infant (n = 130) was matched to two control infants (n = 260) on the case infant's date of birth (±7 days) and the mother's maternal age (<20 years, 20–29, 30–39, and >39 years). All infants were selected from a cohort of eligible term, healthy, in-state infants admitted to the newborn unit postdelivery from January 1, 2016 to May 8, 2017. Data were analyzed using hierarchical conditional logistic regression. Results The incidence of neonatal readmission was 2.2%, and all readmissions occurred within 8.6 days of birth. Earlier gestational age (37 weeks; odds ratio [OR]: 4.11, 95% confidence interval [CI]: 1.79–9.45; 38 weeks OR: 1.29, CI 0.60–2.75; [ref] 39 weeks), jaundice on day two of life (OR: 2.45; CI: 1.40–4.30), maternal group B streptococcus chemoprophylaxis (OR: 2.55; CI: 1.23–5.28 [Ref N/A]) were associated with readmission. Delivery by cesarean section (OR: 0.31, CI: 0.12–0.79) and each milliliter of formula [first three days] (OR: 0.96; CI: 0.993–0.999) were protective. Conclusion Neonatal readmission in healthy term infants may potentially be reduced with identification of modifiable determinants of readmission prior to discharge. Policies to capture the true incidence of neonatal readmissions should include admissions to hospitals other than the birth hospital.
Journal of Perinatology, Oct 1, 2017
We read with interest the randomized controlled trial by Mercer et al. Their study adds valuable ... more We read with interest the randomized controlled trial by Mercer et al. Their study adds valuable information to the debated question of the ideal timing to clamp the cord for term infants. However, in their description of early outcomes, we consider that the formula used to evaluate the relative placental residual blood volume (rPRBV) is prone to ‘mathematical’ bias: as delayed cord clamping allows blood to be transfused from the placenta to the baby, the birth weight (BW) is increased by the intervention, as found in their report and previous studies. Therefore, using an intervention dependant-BW as a denominator to compute rPRBV (rPRBV= PRBV/BW) will amplify differences between immediate and delayed cord clamping groups. The sum of BW and absolute PRBV would not be affected by the timing of cord clamping; this sum could then be used as the fraction’s denominator (rPRBV = PRBV/(PRBV+BW)) to allow a more robust estimation of rPRBV difference. CONFLICT OF INTEREST
DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2010
Coleta do sangue do cordão umbilical. Peridural. Analgesia materna. Atendimento por obstetrizes. ... more Coleta do sangue do cordão umbilical. Peridural. Analgesia materna. Atendimento por obstetrizes. Manejo do recémnascido. Opióides. Uso de oxigênio. Cuidado pele-apele. Aspiração. Termorregulação. Clampeamento do cordão umbilical.
Journal of Midwifery & Women's Health, Sep 10, 2007
Journal of Human Lactation, Mar 11, 2021
Background Maternal worry about infant weight has inconsistently been reported as a breastfeeding... more Background Maternal worry about infant weight has inconsistently been reported as a breastfeeding barrier. Weight monitoring is a critical tool to assess adequacy of infant feeding. Yet, little is known about the intensity of maternal worry about infant weight or associated breastfeeding outcomes. Research aims To examine (1) the frequency and intensity of maternal worry about infant weight; (2) the relationship between worry about weight and use of artificial milk; and 3) the relationship between worry about weight and breastfeeding cessation. Methods A prospective cross-sectional design was used. A questionnaire was completed by women in the United States ( N = 287) from 12 web-based maternal support groups. Results Sixty-three percent of women ( n = 182) had some worry about infant weight. Participants breastfeeding for the first time had more worry ( p = .035). Participants still breastfeeding had less worry about weight compared to those who had stopped (67%, n = 147 vs. 41%, n = 28). Exclusive breastfeeding participants had less worry ( p < .001) compared to those who supplemented with artificial milk. Increased worry was associated with the use of artificial milk within 1 week of birth ( p < .001) and early breastfeeding cessation ( p < .001). Conclusions Worry about weight is a significant breastfeeding barrier. It is associated with first time breastfeeding, less exclusive breastfeeding, use of artificial milk, and earlier breastfeeding cessation. Lactating mothers need anticipatory guidance about expected neonatal weight changes and interventions to help relieve worry about infant weight.
Journal of Perinatology, 2021
Placental transfusion results in a significant decrease in the risk of death for extremely preter... more Placental transfusion results in a significant decrease in the risk of death for extremely preterm infants. With immediate cord clamping (ICC), these infants can leave up to one-half of their normal circulating in utero blood volume in the placenta. Extremely preterm infants are at highest risk of harm from ICC yet are currently the most likely to receive ICC. Receiving a placenta transfusion provides infants with life-saving components and enhanced perfusion. We present some lesser-known but important effects of placental transfusion. New research reveals that enhanced vascular perfusion causes an organ’s endothelial cells to release angiocrine responses to guide essential functions. High progesterone levels and pulmonary artery pressure in the first few hours of life assist with neonatal adaptation. We propose that lack of essential blood volume may be a major factor contributing to inflammation, morbidities, and mortality that preterm infants frequently encounter. Placental transfusion provides enhanced vascular perfusion and reduces the risk of death for preterm infants Enhanced vascular perfusion stimulates endothelial cells to release vital angiocrine messengers to guide normal function and development of neonatal organs High progesterone levels and pulmonary artery pressure in the first 12 h may assist the newborn to adapt to the placental transfusion throughout the body Blood volume conservation is important at birth and during the NICU stay for preterm infants Placental transfusion provides enhanced vascular perfusion and reduces the risk of death for preterm infants Enhanced vascular perfusion stimulates endothelial cells to release vital angiocrine messengers to guide normal function and development of neonatal organs High progesterone levels and pulmonary artery pressure in the first 12 h may assist the newborn to adapt to the placental transfusion throughout the body Blood volume conservation is important at birth and during the NICU stay for preterm infants
Children
Births involving shoulder dystocia or tight nuchal cords can deteriorate rapidly. The fetus may h... more Births involving shoulder dystocia or tight nuchal cords can deteriorate rapidly. The fetus may have had a reassuring tracing just before birth yet may be born without any heartbeat (asystole). Since the publication of our first article on cardiac asystole with two cases, five similar cases have been published. We suggest that these infants shift blood to the placenta due to the tight squeeze of the birth canal during the second stage which compresses the cord. The squeeze transfers blood to the placenta via the firm-walled arteries but prevents blood returning to the infant via the soft-walled umbilical vein. These infants may then be born severely hypovolemic resulting in asystole secondary to the loss of blood. Immediate cord clamping (ICC) prevents the newborn’s access to this blood after birth. Even if the infant is resuscitated, loss of this large amount of blood volume may initiate an inflammatory response that can enhance neuropathologic processes including seizures, hypoxic...
Routledge eBooks, Dec 23, 2022
Rhode Island medical journal, 2019
OBJECTIVE Our objective was to identify patterns of opioid use among pregnant women enrolled in R... more OBJECTIVE Our objective was to identify patterns of opioid use among pregnant women enrolled in RI Medicaid. METHODS This study used linked RI Medicaid and RI Birth Certificate data from 01/01/2006 to 12/31/2016. We examined temporal trends of prescription opioid dispensings and identified risk factors associated with opioids use during pregnancy. RESULTS Among 25,500 RI Medicaid enrolled pregnant women who delivered a live baby from 2008 to 2016, 1,914 (7.5%) received at least one prescription for an opioid medication during pregnancy, 810 (3.2%) were during the first trimester, 633 (2.5%) during the second trimester, and 866 (3.4%) during the third trimester. Of these, 213 (0.8%) women received 3 or more opioids during pregnancy. The prevalence of prescription opioids dispensed in pregnant women increased from 4.9% in 2008 to 9.6% in 2015 (β±SD: 0.66±0.28, P=0.05). CONCLUSIONS Prescription opioid use during pregnancy has increased among women enrolled in RI Medicaid.
Access to safe abortion care has been linked to better maternal and child health outcomes (Sedgh ... more Access to safe abortion care has been linked to better maternal and child health outcomes (Sedgh et al., 2012) and identified as essential for advancing women's economic and social equality (Bengsch, 2015; Lang, 2013). Around the world, nurses, including nurse practitioners (NPs) and certified nurse midwives (CNMs), are integral members of the health care teams that provide care to women considering or electing to have an abortion. Evidence supports NPs and CNMs as safe and effective providers of comprehensive early abortion care, and acceptable to patients (Barnard, Kim, Park, &
Journal of Midwifery & Women's Health, 2019
and the Journal of Midwifery & Women's Health are pleased to present the abstracts from the 2019 ... more and the Journal of Midwifery & Women's Health are pleased to present the abstracts from the 2019 Research Forum podium presentations. The podium presentations were selected in a blinded peer review process and presented at the ACNM Annual Meeting in May 2019. The abstracts of completed research were eligible for presentation and therefore publication. The abstracts presented here demonstrate the breadth and quality of research being conducted about midwifery and women's health by midwifery researchers and our colleagues.
Journal of Midwifery & Women's Health, 2019
and the Journal of Midwifery & Women's Health are pleased to present the abstracts from the 2019 ... more and the Journal of Midwifery & Women's Health are pleased to present the abstracts from the 2019 Research Forum podium presentations. The podium presentations were selected in a blinded peer review process and presented at the ACNM Annual Meeting in May 2019. The abstracts of completed research were eligible for presentation and therefore publication. The abstracts presented here demonstrate the breadth and quality of research being conducted about midwifery and women's health by midwifery researchers and our colleagues.
Children (Basel), Apr 6, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
European Journal of Pediatrics, 2022
European Journal of Pediatrics, 2022
A newborn who receives a placental transfusion at birth from delayed cord clamping (DCC) obtains ... more A newborn who receives a placental transfusion at birth from delayed cord clamping (DCC) obtains about 30% more blood volume than those with immediate cord clamping (ICC). Benefits for term neonates include higher hemoglobin levels, less iron deficiency in infancy, improved myelination out to 12 months, and better motor and social development at 4 years of age especially in boys. For preterm infants, benefits include less intraventricular hemorrhage, fewer gastrointestinal issues, lower transfusion requirements, and less mortality in the neonatal intensive care unit by 30%. Ventilation before clamping the umbilical cord can reduce large swings in cardiovascular function and help to stabilize the neonate. Hypovolemia, often associated with nuchal cord or shoulder dystocia, may lead to an inflammatory cascade and subsequent ischemic injury. A sudden unexpected neonatal asystole at birth may occur from severe hypovolemia. The restoration of blood volume is an important action to protec...
JOGNN: Journal of Obstetric, Gynecologic, and Neonatal Nursing, 2018
Methods Term pregnant women with singleton fetuses were randomized to either ICC (<20 s) or DC... more Methods Term pregnant women with singleton fetuses were randomized to either ICC (<20 s) or DCC (>5 min). At 4 and 12 months of age, the infants’ hemoglobin and ferritin levels were measured and they underwent a non-sedated magnetic resonance imaging scan and neurodevelopmental testing. Institutional review board approval was obtained. Results There were no differences in maternal and infant demographics between groups. Mean cord clamping time was 318 s 158 s (DCC) versus 10 s 5 s (ICC); p < .0001). At 4 months, infants who received DCC had higher ferritin levels (91 ng/ml 57 ng/ml vs. 61 30 ng/ml, p < .04). At 12 months, infants randomized to DCC had significantly greater brain myelin volume in the following brain regions: left and right (R) internal capsule, R parietal, R occipital, R frontal, and R orbital areas. The DCC group had a trend towards better social–emotional performance using the Brief Infant-Toddler Social and Emotional Assessment Competence score than di...
Journal of Perinatology, 2016
Objective-To measure the effects of a five-minute delay (DCC) versus immediate cord clamping (ICC... more Objective-To measure the effects of a five-minute delay (DCC) versus immediate cord clamping (ICC) on residual placental blood volume (RPBV) at birth, and hemoglobin and serum bilirubin at 24 to 48 hours of age. Study Design-In this prospective randomized controlled trial, seventy-three women with term (37 to 41 weeks) singleton fetuses were randomized to DCC (≥5 minutes; n=37) or ICC (<20 seconds; n=36). Results-Maternal and infant demographics were not different between groups. Mean cord clamping time was 303 ± 121 (DCC) versus 23 ± 59 (ICC) seconds (p<0.001) with 10 protocol violations. Cord milking was the proxy for DCC (n = 11) when the provider could not wait. Infants randomized to DCC compared to ICC had significantly less RPBV (20.0 vs 30.8 mL/kg, p<0.001), higher hemoglobin levels (19.4 vs 17.8 g/dL, p=0.002) at 24 to 48 hours, with no difference in bilirubin levels. Conclusions-Term infants had early hematological advantage of DCC without increases in hyperbilirubinemia or symptomatic polycythemia. Keywords delayed cord clamping; umbilical cord milking; hemoglobin; bilirubin; residual placental blood volume; placental transfusion Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:
Quality Nursing, Aug 1, 2002
American Journal of Perinatology, Mar 2, 2020
Objective The aim of this study was to estimate the incidence and identify the factors associated... more Objective The aim of this study was to estimate the incidence and identify the factors associated with neonatal readmission among healthy term infants. Study Design A nested case–control study with matching was conducted at a large level III perinatal hospital with approximately 8,700 deliveries each year. Each case infant (n = 130) was matched to two control infants (n = 260) on the case infant's date of birth (±7 days) and the mother's maternal age (<20 years, 20–29, 30–39, and >39 years). All infants were selected from a cohort of eligible term, healthy, in-state infants admitted to the newborn unit postdelivery from January 1, 2016 to May 8, 2017. Data were analyzed using hierarchical conditional logistic regression. Results The incidence of neonatal readmission was 2.2%, and all readmissions occurred within 8.6 days of birth. Earlier gestational age (37 weeks; odds ratio [OR]: 4.11, 95% confidence interval [CI]: 1.79–9.45; 38 weeks OR: 1.29, CI 0.60–2.75; [ref] 39 weeks), jaundice on day two of life (OR: 2.45; CI: 1.40–4.30), maternal group B streptococcus chemoprophylaxis (OR: 2.55; CI: 1.23–5.28 [Ref N/A]) were associated with readmission. Delivery by cesarean section (OR: 0.31, CI: 0.12–0.79) and each milliliter of formula [first three days] (OR: 0.96; CI: 0.993–0.999) were protective. Conclusion Neonatal readmission in healthy term infants may potentially be reduced with identification of modifiable determinants of readmission prior to discharge. Policies to capture the true incidence of neonatal readmissions should include admissions to hospitals other than the birth hospital.
Journal of Perinatology, Oct 1, 2017
We read with interest the randomized controlled trial by Mercer et al. Their study adds valuable ... more We read with interest the randomized controlled trial by Mercer et al. Their study adds valuable information to the debated question of the ideal timing to clamp the cord for term infants. However, in their description of early outcomes, we consider that the formula used to evaluate the relative placental residual blood volume (rPRBV) is prone to ‘mathematical’ bias: as delayed cord clamping allows blood to be transfused from the placenta to the baby, the birth weight (BW) is increased by the intervention, as found in their report and previous studies. Therefore, using an intervention dependant-BW as a denominator to compute rPRBV (rPRBV= PRBV/BW) will amplify differences between immediate and delayed cord clamping groups. The sum of BW and absolute PRBV would not be affected by the timing of cord clamping; this sum could then be used as the fraction’s denominator (rPRBV = PRBV/(PRBV+BW)) to allow a more robust estimation of rPRBV difference. CONFLICT OF INTEREST
DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2010
Coleta do sangue do cordão umbilical. Peridural. Analgesia materna. Atendimento por obstetrizes. ... more Coleta do sangue do cordão umbilical. Peridural. Analgesia materna. Atendimento por obstetrizes. Manejo do recémnascido. Opióides. Uso de oxigênio. Cuidado pele-apele. Aspiração. Termorregulação. Clampeamento do cordão umbilical.
Journal of Midwifery & Women's Health, Sep 10, 2007
Journal of Human Lactation, Mar 11, 2021
Background Maternal worry about infant weight has inconsistently been reported as a breastfeeding... more Background Maternal worry about infant weight has inconsistently been reported as a breastfeeding barrier. Weight monitoring is a critical tool to assess adequacy of infant feeding. Yet, little is known about the intensity of maternal worry about infant weight or associated breastfeeding outcomes. Research aims To examine (1) the frequency and intensity of maternal worry about infant weight; (2) the relationship between worry about weight and use of artificial milk; and 3) the relationship between worry about weight and breastfeeding cessation. Methods A prospective cross-sectional design was used. A questionnaire was completed by women in the United States ( N = 287) from 12 web-based maternal support groups. Results Sixty-three percent of women ( n = 182) had some worry about infant weight. Participants breastfeeding for the first time had more worry ( p = .035). Participants still breastfeeding had less worry about weight compared to those who had stopped (67%, n = 147 vs. 41%, n = 28). Exclusive breastfeeding participants had less worry ( p < .001) compared to those who supplemented with artificial milk. Increased worry was associated with the use of artificial milk within 1 week of birth ( p < .001) and early breastfeeding cessation ( p < .001). Conclusions Worry about weight is a significant breastfeeding barrier. It is associated with first time breastfeeding, less exclusive breastfeeding, use of artificial milk, and earlier breastfeeding cessation. Lactating mothers need anticipatory guidance about expected neonatal weight changes and interventions to help relieve worry about infant weight.
Journal of Perinatology, 2021
Placental transfusion results in a significant decrease in the risk of death for extremely preter... more Placental transfusion results in a significant decrease in the risk of death for extremely preterm infants. With immediate cord clamping (ICC), these infants can leave up to one-half of their normal circulating in utero blood volume in the placenta. Extremely preterm infants are at highest risk of harm from ICC yet are currently the most likely to receive ICC. Receiving a placenta transfusion provides infants with life-saving components and enhanced perfusion. We present some lesser-known but important effects of placental transfusion. New research reveals that enhanced vascular perfusion causes an organ’s endothelial cells to release angiocrine responses to guide essential functions. High progesterone levels and pulmonary artery pressure in the first few hours of life assist with neonatal adaptation. We propose that lack of essential blood volume may be a major factor contributing to inflammation, morbidities, and mortality that preterm infants frequently encounter. Placental transfusion provides enhanced vascular perfusion and reduces the risk of death for preterm infants Enhanced vascular perfusion stimulates endothelial cells to release vital angiocrine messengers to guide normal function and development of neonatal organs High progesterone levels and pulmonary artery pressure in the first 12 h may assist the newborn to adapt to the placental transfusion throughout the body Blood volume conservation is important at birth and during the NICU stay for preterm infants Placental transfusion provides enhanced vascular perfusion and reduces the risk of death for preterm infants Enhanced vascular perfusion stimulates endothelial cells to release vital angiocrine messengers to guide normal function and development of neonatal organs High progesterone levels and pulmonary artery pressure in the first 12 h may assist the newborn to adapt to the placental transfusion throughout the body Blood volume conservation is important at birth and during the NICU stay for preterm infants
Children
Births involving shoulder dystocia or tight nuchal cords can deteriorate rapidly. The fetus may h... more Births involving shoulder dystocia or tight nuchal cords can deteriorate rapidly. The fetus may have had a reassuring tracing just before birth yet may be born without any heartbeat (asystole). Since the publication of our first article on cardiac asystole with two cases, five similar cases have been published. We suggest that these infants shift blood to the placenta due to the tight squeeze of the birth canal during the second stage which compresses the cord. The squeeze transfers blood to the placenta via the firm-walled arteries but prevents blood returning to the infant via the soft-walled umbilical vein. These infants may then be born severely hypovolemic resulting in asystole secondary to the loss of blood. Immediate cord clamping (ICC) prevents the newborn’s access to this blood after birth. Even if the infant is resuscitated, loss of this large amount of blood volume may initiate an inflammatory response that can enhance neuropathologic processes including seizures, hypoxic...
Routledge eBooks, Dec 23, 2022
Rhode Island medical journal, 2019
OBJECTIVE Our objective was to identify patterns of opioid use among pregnant women enrolled in R... more OBJECTIVE Our objective was to identify patterns of opioid use among pregnant women enrolled in RI Medicaid. METHODS This study used linked RI Medicaid and RI Birth Certificate data from 01/01/2006 to 12/31/2016. We examined temporal trends of prescription opioid dispensings and identified risk factors associated with opioids use during pregnancy. RESULTS Among 25,500 RI Medicaid enrolled pregnant women who delivered a live baby from 2008 to 2016, 1,914 (7.5%) received at least one prescription for an opioid medication during pregnancy, 810 (3.2%) were during the first trimester, 633 (2.5%) during the second trimester, and 866 (3.4%) during the third trimester. Of these, 213 (0.8%) women received 3 or more opioids during pregnancy. The prevalence of prescription opioids dispensed in pregnant women increased from 4.9% in 2008 to 9.6% in 2015 (β±SD: 0.66±0.28, P=0.05). CONCLUSIONS Prescription opioid use during pregnancy has increased among women enrolled in RI Medicaid.
Access to safe abortion care has been linked to better maternal and child health outcomes (Sedgh ... more Access to safe abortion care has been linked to better maternal and child health outcomes (Sedgh et al., 2012) and identified as essential for advancing women's economic and social equality (Bengsch, 2015; Lang, 2013). Around the world, nurses, including nurse practitioners (NPs) and certified nurse midwives (CNMs), are integral members of the health care teams that provide care to women considering or electing to have an abortion. Evidence supports NPs and CNMs as safe and effective providers of comprehensive early abortion care, and acceptable to patients (Barnard, Kim, Park, &
Journal of Midwifery & Women's Health, 2019
and the Journal of Midwifery & Women's Health are pleased to present the abstracts from the 2019 ... more and the Journal of Midwifery & Women's Health are pleased to present the abstracts from the 2019 Research Forum podium presentations. The podium presentations were selected in a blinded peer review process and presented at the ACNM Annual Meeting in May 2019. The abstracts of completed research were eligible for presentation and therefore publication. The abstracts presented here demonstrate the breadth and quality of research being conducted about midwifery and women's health by midwifery researchers and our colleagues.
Journal of Midwifery & Women's Health, 2019
and the Journal of Midwifery & Women's Health are pleased to present the abstracts from the 2019 ... more and the Journal of Midwifery & Women's Health are pleased to present the abstracts from the 2019 Research Forum podium presentations. The podium presentations were selected in a blinded peer review process and presented at the ACNM Annual Meeting in May 2019. The abstracts of completed research were eligible for presentation and therefore publication. The abstracts presented here demonstrate the breadth and quality of research being conducted about midwifery and women's health by midwifery researchers and our colleagues.
Children (Basel), Apr 6, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
European Journal of Pediatrics, 2022
European Journal of Pediatrics, 2022
A newborn who receives a placental transfusion at birth from delayed cord clamping (DCC) obtains ... more A newborn who receives a placental transfusion at birth from delayed cord clamping (DCC) obtains about 30% more blood volume than those with immediate cord clamping (ICC). Benefits for term neonates include higher hemoglobin levels, less iron deficiency in infancy, improved myelination out to 12 months, and better motor and social development at 4 years of age especially in boys. For preterm infants, benefits include less intraventricular hemorrhage, fewer gastrointestinal issues, lower transfusion requirements, and less mortality in the neonatal intensive care unit by 30%. Ventilation before clamping the umbilical cord can reduce large swings in cardiovascular function and help to stabilize the neonate. Hypovolemia, often associated with nuchal cord or shoulder dystocia, may lead to an inflammatory cascade and subsequent ischemic injury. A sudden unexpected neonatal asystole at birth may occur from severe hypovolemia. The restoration of blood volume is an important action to protec...
JOGNN: Journal of Obstetric, Gynecologic, and Neonatal Nursing, 2018
Methods Term pregnant women with singleton fetuses were randomized to either ICC (<20 s) or DC... more Methods Term pregnant women with singleton fetuses were randomized to either ICC (<20 s) or DCC (>5 min). At 4 and 12 months of age, the infants’ hemoglobin and ferritin levels were measured and they underwent a non-sedated magnetic resonance imaging scan and neurodevelopmental testing. Institutional review board approval was obtained. Results There were no differences in maternal and infant demographics between groups. Mean cord clamping time was 318 s 158 s (DCC) versus 10 s 5 s (ICC); p < .0001). At 4 months, infants who received DCC had higher ferritin levels (91 ng/ml 57 ng/ml vs. 61 30 ng/ml, p < .04). At 12 months, infants randomized to DCC had significantly greater brain myelin volume in the following brain regions: left and right (R) internal capsule, R parietal, R occipital, R frontal, and R orbital areas. The DCC group had a trend towards better social–emotional performance using the Brief Infant-Toddler Social and Emotional Assessment Competence score than di...