Thursday, January 19, 2017

Later avnavling prevents anemia – Mynewsdesk (press release)

To wait a couple of minutes to cut the umbilical cord might prevent iron deficiency in children up to six months of age. According to a new study from Uppsala university published in the journal JAMA Pediatrics, and the results are of great importance in societies where it is common that children have a blood – and iron deficiency. The study is made in Nepal.

Anemia, anemia, affects more than forty percent of all children under five in the world. Anaemia affects the mental as well as physical performance, and can provide long-term deterioration of growth and development. Approximately half of all children with anemia have it because of iron deficiency. To avnavla – to cut the umbilical cord – on the children late, that is to say, after three minutes, have been shown to prevent iron deficiency up to six months of age.

About a third of the child’s blood is in the placenta when it is born. If you then cut the umbilical cord directly, early avnavling, stops the blood left in the placenta and goes to waste (or may be stored in stem cell banks). If, instead of waiting three minutes, the greater part of the blood to drain back to the child who will then receive an additional blood transfusion, about a decilitre of blood, which corresponds to approximately two liters in an adult. In comparison, a normal blood donor leave 4-5 decilitre of blood.

the Blood contains many red blood cells which contains hemoglobin, which contains much iron, and the extra deciliter of blood a child receives contains iron, which is equivalent to 3-4 months of needs for an infant.

the WHO recommends avnavling in a minute or later and the american assembly of obstetrician (ACOG) recommends avnavling at 30-60 seconds, or later.

How was the study?

We are fortunate/randomized 540 children to the early avnavling (less than 60 seconds) or late avnavling (more than 180 seconds). The children were born at a maternity hospital in Kathmandu, Nepal. In Nepal, approximately 70% of children under one year anemia. The children were followed up at eight and twelve months of age with blood test, where we checked the blood count (hemoglobin) and järnvärde (ferritin).

We have previously shown that the late avnavlade children in Sweden had more iron in the body at four months of age and that the proportion of children with iron deficiency decreased by 90 percent, from 5.7 percentage points to 0.6 percentage points. We have also been able to show that children’s general ability and development not differ at the age of four, but the late avnavlade the children had better fine motor skills.

What was the result?

At eight months of age decreased the prevalence of anemia by nine per cent and still at the age of twelve months were eight per cent fewer children anemia. The children in the late avnavlade group had a generally higher hemoglobinvärden and the proportion of children who had iron deficiency at eight months of age decreased significantly, over 40 per cent.

Are the results safe?

in the Middle of the actual study, in may 2015, was the major earthquakes in Nepal. It was difficult to collect all the children for sampling at eight and twelve months of age. At eight months, three out of four (74 %) and at twelve months of age came less than two out of three (62 %). We had anticipated these problems and had, therefore, with 188 children in the study from the beginning.

just Over a fifth (23 %) of children who were randomly assigned to the late avnavling was still early avnavlade. Their results were counted in among the late avnavlade according to the so-called "intention to treat". If you excluded them, they were positive effects of late avnavling even clearer.

What is research impact?

We have in this study shown that the late avnavling, after more than three minutes, has a great importance in societies where it is common that children have a blood – and iron deficiency. Then avnavling after three minutes is a free action which we have not seen any side effects of. We hope that those who write the recommendation on avnavling in the future will want to carry out then avnavling after three minutes around the world.

Andersson O et al; the Can Delayed Umbilical Cord Clamping to Reduce Infant Anemia at Age 8, 12 Months? JAMA Pediatrics, January 17, 2017, doi:10.1001/jamapediatrics.2016.3971

For more information:

Ola Andersson, a pediatrician and researcher in international maternal and child health department of women’s and children’s health, Uppsala university, ola.andersson@kbh.uu.se, 0709-66 41 80

Previous studies on the avnavling:

the Umbilical cord can save lives (2012-04-20)

Better fine motor skills with late avnavling (15-05-26)

LikeTweet

No comments:

Post a Comment