Effect of timing of umbilical cord clamping on maternal and neonatal outcomes: A protocol for systematic review and network meta-analysis

BACKGROUND: Umbilical cord clamping is one of the most commonly used medical or complementary medical interventions. The different timing of cord clamping may have any significant impact on public health. However, the results remain controversial. The aim of the study was to evaluate and compare the effect of different timing of umbilical cord clamping on maternal and neonatal outcomes. METHODS: A systematic literature search for relevant articles will be conducted in the Cochrane Central Register of Controlled Trials, PubMed, Embase, and Chinese Biomedical Literature Database from their inception to December 2018. Any randomized controlled trial (RCT), case-control study, observational study, that reported the effect of different timing of cord clamping will be included regardless of sample size. There are no language restrictions. Mortality and risk of iron-deficiency anemia will be used to assess the clinical effect. Risk of bias assessment of the included RCTs will be conducted by the Cochrane risk of bias tool and the Newcastle–Ottawa Scale is used to assess observational studies. All statistical analyses will be performed using Stata V.15.0. A modified version of Grades of Recommendation, Assessment, Development, and Evaluation will be used to assess the quality of evidence in network meta-analysis (NMA). RESULTS: The results will be published in a peer-reviewed journal. CONCLUSION: This will be the first NMA to evaluate and compare the effect of different timing of umbilical cord clamping. We hope that the results of this NMA will help clinicians and caregivers make more appropriate choices when clamping umbilical cord.