ISRCTN ISRCTN48735857
DOI https://doi.org/10.1186/ISRCTN48735857
Secondary identifying numbers NTR424
Submission date
22/11/2005
Registration date
22/11/2005
Last edited
13/08/2009
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Pregnancy and Childbirth
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr P.F. Rheenen, van
Scientific

Brinklaan 6
Groningen
9722 BC
Netherlands

Email p.f.vanrheenen@gmail.com

Study information

Study designRandomised single blind active controlled parallel group trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typePrevention
Scientific title
Study objectivesAnaemia is recognized as an important cause of morbidity and mortality in under fives. When associated with iron deficiency, anaemia may impair mental and motor development. There are indications that with iron therapy anaemic children fail to catch up to non-anaemic children. Primary prevention of iron deficiency and malaria in young children could have substantive effect on reducing child mortality and morbidity.
Key strategies for the reduction of infant anaemia are: iron supplementation in pregnancy and infancy; iron-fortification of infant formula; chemoprophylaxis and prompt anti-malarial treatment in pregnancy and infancy; and use of insecticide-treated nets to reduce exposure to malaria. Combinations of the aforementioned strategies can synergistically improve anaemia. However, most have had limited success in developing countries due to financial, logistic and technical constraints.
In view of this there is interest in improving the iron status of infants by enhancing their red cell mass with late umbilical cord clamping. This intervention is said to increase haemoglobin (Hb) concentration by 2-3 months of age, especially in infants born to anaemic mothers. Whether this low cost delivery procedure is effective in reducing anaemia in infants from resource-poor countries that are malaria-endemic has never been evaluated.
Ethics approval(s)Received from local medical ethics committee
Health condition(s) or problem(s) studiedPregnancy
InterventionPregnant women are randomised to either the intervention of delayed cord clamping (DCC) or immediate cord clamping (ICC). ICC is the routine standard of care in Mpongwe Mission Hospital at the time of the trial, and is usually done within 20 s after delivery. Mother-infant couples assigned to this procedure are thus considered the control group. In the DCC group the umbilical cord is clamped after the cord stops pulsating. The exact time is recorded by use of a stopwatch. A recently performed pilot study showed that cord pulsations normally cease after 3.5 minutes. Following vaginal birth the infant is placed between the legs of the mother (approximately 15 cm below the vaginal introitus), dried, and wrapped in a warm towel.
Intervention typeOther
Primary outcome measurePost-treatment Hb level in relation to pre-treatment values and the proportion of non-anaemic infants at two, four and six months after birth.
Secondary outcome measuresPossible side effects of DCC in infants (Packed Cell Volume [PCV] changes 1 day postpartum; clinical signs of hyperviscosity syndrome and hyperbilirubinaemia) and mothers (Hb level one day after delivery in relation to antenatal values).
Overall study start date01/05/2004
Completion date31/01/2005

Eligibility

Participant type(s)Patient
Age groupAdult
SexFemale
Target number of participants91
Key inclusion criteriaFull term pregnant women delivering in Mpongwe Mission Hospital are candidates for inclusion in the study.
Key exclusion criteria1. Twin pregnancy
2. History of post partum haemorrhage (PPH) >500 ml
3. Gestational diabetes
4. (Pre)eclampsia
5. Placental separation before delivery
6. Caesarean section
7. Tight nuchal cord
8. Need for neonatal resuscitation
9. Major congenital abnormalities (e.g. neural tube defects)
Criteria 1-4 are applied before randomisation.
Criteria 5-9 can only be assessed after randomisation.
Date of first enrolment01/05/2004
Date of final enrolment31/01/2005

Locations

Countries of recruitment

  • Netherlands
  • Zambia

Study participating centre

Brinklaan 6
Groningen
9722 BC
Netherlands

Sponsor information

Liverpool School of Tropical Medicine (UK)
University/education

Pembroke Place
Liverpool
L35QA
England
United Kingdom

ROR logo "ROR" https://ror.org/03svjbs84

Funders

Funder type

Other

Liverpool-Amsterdam Cooperation Fund

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/05/2007 Yes No