479 - Delayed Cord Clamping (DCC) on Clinical Outcomes of Infants of Diabetic Mothers

Poster Number: 479
Publication Number: 479.2769

Background: According to the American College of Obstetrics and Gynecologist and the American Academy of Pediatrics, delayed cord clamping (DCC) is recommended for all vigorous term infants for 30-60 seconds at birth due to its benefits to newborns. The incidence of diabetes mellitus (DM), pre-gestational or gestational, is a common complication in pregnancy and carries a higher risk of congenital abnormalities and neonatal comorbidities. Infants born to mothers with DM (IDM) are at greatest risk of hyperbilirubinemia, polycythemia, hypoglycemia, electrolyte disturbances, and respiratory distress syndrome. There are limited data on the effect of DCC and comorbidities in IDM.

Objective: To evaluate the effect of DCC on the clinical outcomes in IDM as measured by hyperbilirubinemia, hypoglycemia, polycythemia, respiratory distress, neonatal intensive care unit (NICU) admission, and length of stay (LOS).

Design/Methods: Retrospective chart review of full term singleton IDM at a single community hospital in Queens, New York from June 1, 2022 to April 30, 2023. Data extracted from the mother’s EHR included demographics, maternal body mass index (BMI), type of DM, and mode of delivery; from the neonate’s EHR, gestational age, gender, Apgar score, birth weight, length, head circumference, discharge weight, hyperbilirubinemia, hypoglycemia, polycythemia, respiratory distress, NICU admission, length of stay (LOS), and readmission for hyperbilirubinemia. Infants who had DCC were compared to those who did not have DCC (NDCC). Data were analyzed using SPSS, percentages, student t-test, chi-square, and Fisher’s exact test, p< 0.05 was considered significant.

Results: Of 584 IDM, 397 neonates met the inclusion criteria. The DCC group included 211 (53%) and the NDCC group included 186 (46%) neonates. There were no significant differences between the two groups for maternal and infant baseline characteristics, table 1. There were no significant differences between the two groups regarding NICU admission (p=0.31), feeding mode (p=0.76), hypoglycemia (p= 0.19), respiratory distress (p=0.7), polycythemia (p=0.26), LOS (p=0.07) and hyperbilirubinemia hospitalization after discharge (p=0.98), table 2. Hyperbilirubinemia at birth hospitalization was significantly higher in the NDCC group than in the DCC group (p < 0.001), table 2.

Conclusion(s): DCC did not alter the outcomes in IDM as measured by hypoglycemia, polycythemia, respiratory distress, NICU admission and LOS. The absence of significant differences between the two groups validate the safety of DCC in this group of neonates.