European Journal of Cardiovascular Medicine

Background: The transition from intrauterine to extrauterine life is a critical period for newborns, necessitating optimal cord management techniques. This randomized controlled trial conducted in Tertiary Care Medical Institute which compared intact umbilical cord milking (I-UCM) to delayed cord clamping (DCC) and evaluates their impact on neonatal serum ferritin levels and iron status. Methods: Pregnant women were randomly assigned to the I-UCM or DCC group. Neonatal serum ferritin levels were assessed at three months of age. Incidence of anemia, prevalence of iron deficiency, and safety profiles were examined. Associations between maternal/neonatal factors and serum ferritin levels were explored. Results: I-UCM resulted in significantly higher serum ferritin levels compared to DCC (p < 0.001). The incidence of neonatal anemia was lower in the I-UCM group (p = 0.036), with a trend towards reduced iron deficiency (p = 0.072). Both techniques exhibited favorable safety profiles. Maternal iron status and gestational age positively influenced serum ferritin levels in both groups, while birth weight showed no significant impact. Apgar scores were negatively associated with serum ferritin levels. Conclusion: I-UCM demonstrates superiority in enhancing neonatal iron status, reducing anemia incidence, and displaying a favorable safety profile when compared to DCC in the unique context of Uttarakhand, India. This study emphasizes the importance of tailoring cord management practices to regional characteristics and supports the adoption of I-UCM as a viable alternative.