Effect of Time of Cord Clamping on Serum Bilirubin Level among Full Term Babies Born at Tikur Anbessa Specialized Hospital: A Randomized Control Trial.

No Thumbnail Available



Journal Title

Journal ISSN

Volume Title


Addis Abeba University


Background: The right timing for umbilical cord clamping has been a topic of interest for a very long time. Delayed cord clamping above one minute has linked with short and long-term nutritional and developmental benefits; otherwise delaying cord clamping associated with elevated serum bilirubin level as potential harm that could lead to jaundice requiring phototherapy at the early ages of life. Objective: To evaluate the effect of the time of cord clamping on the serum bilirubin level and measure the serum bilirubin level difference between immediate and delayed cord clamping groups within 24 hours of birth from October 2019 - January 2020. Methods: This study is ethically cleared three-arm, single blinded, randomized controlled study among healthy, full term neonates born in Tikur Anbessa Specialized Hospital, Ethiopia. A total of 141term babies calculated with 95% CI and 90% power as samples and enrolled in the study after screening for eligibility and have their mothers’ consent. Study participants were randomly assigned across the two arms of the study; immediate cord clamping (< 1 minute and delayed cord clamping (1-3 minutes). The newborns are assessed for the outcomes at the age of 24 hour and before discharge to home using bilirubinometry and Bhutan nomogram. Basic descriptive analysis conducted to assess the maternal social, obstetric and demographic characteristics with number and percentage. Pearson Chi-square, Fisher’s exact and Kruskal Wallis tests used to compare the association between maternal, fetal factors and time of cord clamping by groups. Simple and linear regression analysis used to predict serum bilirubin level from the predictor variables. Result: Maternal demographic, social and obstetrics factors were not different between the groups except labour duration that had a P-value < 0.05. Time of cord clamping was not a significant predictor of total serum bilirubin levels at the age of 24 hours rather Cord blood total serum bilirubin (TSB) (coef. 0.24) and bilirubin nomogram high risk zone (Coef. 6.25) were significant predictors with P-value of 0.011 and < 0.001 respectively. Conclusion: Time of umbilical cord clamping have no significant association with the total serum bilirubin level of neonates at least within 24 hours of birth.



Cord clamping,serum bilirubin