Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Effect of Timing of Umbilical Cord Clamping on Anaemia at 8 and 12 Months and Later Neurodevelopment in Late Pre-term and Term Infants; a Facility-based Randomized-controlled Trial in Nepal
Brief Summary: The investigators plan a study to randomize 540 children in Nepal to early (≤30 seconds) or late (≥180 seconds) clamping of the umbilical cord at birth. The children will be followed with blood tests (hemoglobin and ferritin) at 8 and 12 months of age, and their development is evaluated by questionnaire (Ages \& Stages Questionnaire ) at 12 months of age, and by testing (Bayley -III) at 18-24 months of age. By implementing the project in a country with a high proportion of anemia at one year of age (about 75%), we can reduce the number of children in the study and still achieve significant results.

Iron deficiency is a global health problem and causes anemia and impaired neurodevelopment in children. Anemia is estimated by WHO to occur among 25% of all children before school age, and the corresponding figure in Europe is 3-9 %.

By waiting 3 minutes to clamp the cord after birth, a large part of the child's blood volume remaining in the placenta is transfused over to the child's body. Research shows that the neonate's blood volume can increase by about 40% and this blood contains 3 to 4 months' supply of iron. In Sweden, we have shown that late clamping of the umbilical cord could reduce iron deficiency in children at four months of age by 90%. Globally, most countries practice early cord clamping and the child is deprived of the placental blood transfusion. The hypothesis of the study is that by delaying the clamping of the umbilical cord, anemia at 8 and 12 months will be reduced an this in turn will be beneficial for the childrens development.

The project will be implemented at Paropakar Maternity and Women 's Hospital, Kathmandu. It hosts approximately 23,000 births annually.


Options:
A: Arm Label: Early cord clamping (ECC); Type: OTHER; Interventions: Procedure: Early (≤30 seconds) cord clamping | Arm Label: Delayed cord clamping (DCC); Type: OTHER; Interventions: Procedure: Delayed (≤180 seconds) cord clamping | Intervention Type: PROCEDURE; Name: Early (≤30 seconds) cord clamping; Assigned to Arm(s): Early cord clamping (ECC) | Intervention Type: PROCEDURE; Name: Delayed (≤180 seconds) cord clamping; Assigned to Arm(s): Delayed cord clamping (DCC)
B: Arm Label: Umbilical Cord Milking; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Umbilical Cord Milking | Arm Label: Delayed Cord Clamping; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Delayed Cord Clamping | Intervention Type: PROCEDURE; Name: Umbilical Cord Milking; Assigned to Arm(s): Umbilical Cord Milking | Intervention Type: PROCEDURE; Name: Delayed Cord Clamping; Assigned to Arm(s): Delayed Cord Clamping
C: Arm Label: immediate umbilical cord clamping; Type: ACTIVE_COMPARATOR; Interventions: Procedure: immediate umbilical cord clamping | Arm Label: Milking the umbilical cord at birth; Type: EXPERIMENTAL; Interventions: Procedure: Milking the umbilical cord at birth | Intervention Type: PROCEDURE; Name: Milking the umbilical cord at birth; Assigned to Arm(s): Milking the umbilical cord at birth | Intervention Type: PROCEDURE; Name: immediate umbilical cord clamping; Assigned to Arm(s): immediate umbilical cord clamping
D: Arm Label: Early umbilical cord clamping (control); Type: NO_INTERVENTION; Interventions: N/A | Arm Label: Delayed umbilical cord clamping; Type: EXPERIMENTAL; Interventions: Procedure: Delayed umbilical cord clamping | Intervention Type: PROCEDURE; Name: Delayed umbilical cord clamping; Assigned to Arm(s): Delayed umbilical cord clamping

Answer: A