RCT studies have showed conflicting results in situations with similar research objectives and objects
and generate doubts regarding effectiveness, fundamentation, indications and results of several health
practices. These doubts motivated the construction of a new paradigm, called Evidence Based Medicine
(EBM). As the EBM precepts were incorporated into other disciplines, it started to be called EvidenceBased Practice (EBP)
The EBP previews methodologies and processes in order to identify evidence of whether a certain
treatment or diagnosis is effective, strategies to evaluate the quality of studies and mechanisms to
implement it in care
The classical definition of EBM is credited to David Sackett (Canada): conscious, explicit and sensate use
of the best evidence available in decision making about patient care, added to the physician’s
experience and the patient’s preferences(6). EBP aims to improve care through the identification and
promotion of workable practices and, at the same time, through the elimination of inefficient and
prejudicial ones(7), minimizing the gap between the generation of evidence and its application in patient
care.
Data analyses included two-sided Pearson’s chi-square tests, t-tests, and Wilcoxon rank-sum tests for non-normally
distributed variables. Odds ratios and 95% confidence intervals were examined as appropriate. Primary analyses
were conducted using intention-to-treat, and sensitivity analyses were conducted using actual treatment in order
to assess the robustness of the findings and to examine results of the biologic variables.
This is the first study of DCC to be conducted in the United States on healthy term infants and the first in North
America since 1980.21 It is also the most recent study to use a five-minute delay with infants placed skin-to-skin on
the maternal abdomen. In 2012, the ACOG statement on DCC offered a consensus that evidence was lacking to
recommend DCC or UCM for term infants. This current study is designed to examine short-term and longtermoutcomes over a two-year span. In this report, we have shown that term infants with DCC of five minutes (or
UCM x 5) have lower amounts of RPBV associated with higher hematocrit and hemoglobin at 24 to 48 hours and no
increase in jaundice, symptomatic polycythemia, or other adverse effects.
A partially blinded, randomized controlled trial was conducted at a level III maternity hospital in
the US. Seventy-three healthy term pregnant women and their singleton fetuses were randomized to
either delayed
umbilical cord clamping (DCC, >5 minutes) or immediate clamping (ICC, <20 seconds). At 4 months of
age, blood
was drawn for ferritin levels. Neurodevelopmental testing (Mullen Scales of Early Learning) was
administered, and
brain myelin content was measured with magnetic resonance imaging. Correlations between myelin
content and
ferritin levels and group-wise DCC vs ICC brain myelin content were completed.