Epidemiological Investigation on the Current Practice of Umbilical Cord Clamping in China

Abstract

Objective Despite known benefits, the timing of and method used for umbilical cord clamping (UCC) in neonates remain controversial in China, as well as internationally. The objective of this study was to assess knowledge, attitudes, and practice of UCC amongst health care providers in China, as recommended by medical professional organizations.

Study Design A web-based questionnaire on cord clamping practices was administered to midwives, obstetricians, and neonatologists in 126 hospitals from 16 provinces. The provinces were selected from seven different regions of China.

Results A total of 5,005 (60.5% of eligible respondents) health care providers returned completed questionnaires. The awareness rates for immediate cord clamping (ICC) and delayed cord clamping (DCC) were over 85%, but the implementation rate for DCC was relatively low (ICC 58.3% vs. DCC 41.6%). Most neonates were placed below the introitus (92.8%) during cord clamping and this correlated with the route of delivery. The choice of UCC was impelled by different factors. Benefits for neonates influenced the choice of ICC (50%) and promoting a larger blood volume to stabilize systemic circulation influenced the choice of DCC (92.3%). Majority (91.5%) of respondents acquiesced that it was necessary to develop national clinical guidelines for UCC.

Conclusion The majority of obstetricians, neonatologists, and midwives who participated in this study had a positive perception of DCC. However, this did not translate to daily practice. The practice of UCC is variable and there are no standard guidelines.

Key Points

• The first large-scale epidemiological investigation of umbilical cord ligation is in China.

• The survey included three commonly used umbilical cord clamping methods.

• The respondents included neonatologists.

Keywords

umbilical cord clamping - neonate - epidemiology - China

Note

This study was not deemed as human research by the Institutional Review Board of Shanghai Jiao Tong University School of Medicine as the questionnaire did not involve any human or animal experiments, so no ethics approval was required for this research. The survey was conducted on a voluntary basis and all questionnaires were returned anonymously.

Authors' Contributions

J.Z. and L.X. conceived, designed, and implemented the study, and wrote the initial draft of the manuscript. L.X., Y.W., and H.A. conceptualized the study and edited the manuscript. All authors read and approved the manuscript.

Publikationsverlauf

Eingereicht: 13. März 2020

Angenommen: 14. Juli 2020

Artikel online veröffentlicht:
07. Dezember 2020

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