The goal of this study is to evaluate whether delayed cord clamping improves early neonatal outcomes compared with immediate clamping in preterm birth.
Preterm infants are at higher risk of neonatal complications, and the timing of cord clamping may influence placental transfusion and neonatal adaptation after birth. Delayed cord clamping may increase blood volume, improve iron stores, and reduce some neonatal morbidities, while immediate cord clamping is still commonly practiced in many settings.
In this study, preterm newborns are assigned to either delayed or immediate cord clamping according to a predefined protocol. Early neonatal outcomes, including respiratory status, need for resuscitation, hemoglobin levels, and early morbidity and mortality, will be assessed.
The study is conducted in a tertiary maternity center in Tunisia.
Preterm neonates born at gestational age between 32 and 37 weeks
Live-born infants delivered in the study center
Singleton pregnancies
Parental consent obtained when applicable according to institutional ethical requirements
Major congenital malformations or chromosomal abnormalities
Need for immediate advanced resuscitation at birth
Severe fetal distress requiring emergency obstetric intervention incompatible with protocol allocation
Placental conditions contraindicating delayed cord clamping (e.g., placental abruption with maternal instability, placenta previa bleeding, Placenta accreta spectrum)