Assessment of Timing of Umbilical Cord Clamping In New-Borns and Its Associated Factors At Birth in Addis Ababa Public Hospitals, Ethiopia 2025
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Date
2025
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Addis Ababa Univertiy
Abstract
The time of umbilical cord clamping is vital for newborn iron levels, as blood continues to flow between the newborn and placenta shortly after birth. The WHO recommends delaying umbilical cord clamping for at least one minute, as immediate clamping can reduce the infant’s blood volume, leading to lower iron stores and potential neurodevelopmental risks. Objective: To assess the time of umbilical cord clamping in newborns and its associated factors at birth in selected public hospitals, Addis Ababa, Ethiopia 2025. Method: Institutional- based cross- sectional study design was conducted from March 20, 2025, to April 20, 2025, in Addis Ababa four randomly selected public hospitals. A systematic random sampling technique was used and 423 study participants were selected. Primary and secondary data were collected through direct observation and review of medical records in both cesarean and vaginal delivery rooms, using an adapted checklist tool. Data were collected using the Kobo Toolbox platform and then exported to SPSS version 25 for analysis. Binary logistic regression was used for the analysis. Multivariable logistic regression models were applied and significant variables were identified having p- value less than 0.05 with AOR and 95% CI. Results: Total respondent were 394 with 94% response rate, the results showed that newborns who receive optimal /delayed cord clamping were 38.3%. The mean and median of cord clamping were 48.33±28.88 and 46 respectively. Multivariate analysis showed that, newborn delivered via caesarian section were 97.4% less likely to receive delayed cord clamping (AOR=0.026, 95% CI: 0.010-0.066), Additionally, newborns of mother who experienced a perennial tear were 85% times less likely to received delayed cord clamping (AOR=0.150, 95%CI:0.066-0.337), Similarly, newborns attended by midwives were 3.078 times more likely to receive delayed cord clamping compared to those delivered by obstetrician (AOR=3.0378, 95% CI: 1.236-7.661), The odd of receiving delayed cord clamping in newborns were 58.5% less likely among mother having Meconium Stained Amniotic Fluid (AOR=0.415, 95% CI: 0.202-0.852). Delivery conducted with team work was 9.538 times more likely to receive delayed cord clamping (AOR=9.538, 95% CI: 3.118-29.172.
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Conclusion and recommendation: This study revealed that the overall practice of delayed cord clamping was suboptimal as compared to early cord clamping, with only 38.3% of newborns receiving delayed cord clamping. In this study, timing of umbilical cord clamping were significantly associated with Mode of delivery, type of birth attendant, presence of meconium –stained amniotic fluid, perennial tears, presence of a delivery team. The majority of the newborns were received early cord clamping, which was fell below the standards set by the WHO, which advocate that all newborns should receive delayed cord clamping unless immediate intensive care is required. It is recommended that hospitals and other stalk holder will develop standardized protocols for delayed cord clamping and emphasize evidenced based practiced to ensure that health care provider adheres to clinical guideline for optimal newborn care.
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Keywords
Delaying cord clamping, early cord clamping, new born, term, Preterm