{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T10:31:56Z","timestamp":1785493916744,"version":"3.56.0"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"15","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:p>Objective\u2003The average time for umbilical cord separation in term neonates is 7 to 10 days. Prematurity, phototherapy, prolonged duration of antibiotic treatment, and parenteral nutrition are other factors which were demonstrated to delay cord separation. In the previous studies including greater premature infants, the time of separation of the umbilical cord was shown to vary 2 to 3 weeks. We aimed to determine the cord separation time and associated factors in very-low-birth-weight (VLBW) infants.<\/jats:p><jats:p>Study Design\u2003In this retrospective study, VLBW infants (birth weight [BW] &lt;1,500\u2009g, gestational age [GA]\u2009&lt;\u200932 weeks) without umbilical catheterization were included. Specific cord care was not applied. The cord separation time, gender, mode of delivery, presence of sepsis, duration of antibiotic treatment, serum free thyroxine, free triiodothyronine (FT3), thyroid-stimulating hormone, lowest leukocyte, polymorphonuclear leukocytes (PMNLs), and platelet counts were recorded.<\/jats:p><jats:p>Results\u2003The study included 130 infants (GA: 29\u2009\u00b1\u20092 weeks, BW: 1,196\u2009\u00b1\u2009243\u2009g). Mean cord separation time was 14\u2009\u00b1\u20095 days, while 95th percentile was 22nd day of life. A positive correlation was demonstrated between duration of antibiotic treatment and cord separation time (p\u2009&lt;\u20090.001, r: 0.505). Cord separation time did not differ regarding gender or mode of delivery. Corrected leukocyte count (p\u2009=\u20090.031, r: \u22120.190) and PMNL count (p\u2009=\u20090.022, r: \u22120.201), and serum FT3 level (p\u2009=\u20090.003, r: \u22120.261) were found to be negatively correlated with cord separation time. The cord separation time was found to be delayed in the presence of sepsis (with sepsis: 18\u2009\u00b1\u20097 days and without sepsis: 13\u2009\u00b1\u20093 days; p\u2009=\u20090.008). Sepsis was found to delay the cord separation time beyond second week (odds ratio\u2009=\u20096.30 [95% confidence interval: 2.37\u201315.62], p\u2009&lt;\u20090.001).<\/jats:p><jats:p>Conclusion\u2003The 95th percentile for cord separation time was 22nd day. Sepsis might be either the reason or the consequence of delayed cord detachment. The exact contribution of low serum FT3 levels to the process of cord separation should be investigated in further studies.<\/jats:p><jats:p>Key Points<\/jats:p>","DOI":"10.1055\/s-0041-1726035","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T23:42:19Z","timestamp":1614814939000},"page":"1682-1687","source":"Crossref","is-referenced-by-count":1,"title":["Umbilical Cord Separation Time and Influencing Factors in Very-Low-Birth-Weight Preterm Neonates"],"prefix":"10.1055","volume":"39","author":[{"given":"Sezin","family":"Unal","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nihal","family":"Demirel","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Yildirim Beyazit University Hospital, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zehra","family":"Arslan","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bet\u00fcl","family":"Tokgoz-Cuni","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilek","family":"Ulubas-Isik","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet Yagmur","family":"Bas","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Yildirim Beyazit University Hospital, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,3,3]]},"reference":[{"key":"ref1","first-page":"179","article-title":"Umbilical cord: factors which influence the separation time","volume":"31","author":"E Sarwono","year":"1991","journal-title":"Paediatr Indones"},{"issue":"02","key":"ref2","first-page":"220","article-title":"Umbilical cord separation in the normal newborn","volume":"142","author":"A H Novack","year":"1988","journal-title":"Am J Dis Child"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1007\/BF00444944","article-title":"The time of separation of the umbilical cord","volume":"146","author":"A M Oudesluys-Murphy","year":"1987","journal-title":"Eur J Pediatr"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"25","DOI":"10.4103\/jcn.JCN_91_17","article-title":"Effect of topical application of human breast milk versus chlorhexidine versus dry cord care on bacterial colonization and clinical outcomes of umbilical cord in preterm newborns","volume":"7","author":"D Lyngdoh","year":"2018","journal-title":"J Clin Neonatol"},{"issue":"15","key":"ref5","first-page":"32","article-title":"Midwifery: umbilical cord care in pre-term babies","volume":"8","author":"J Bain","year":"1994","journal-title":"Nurs Stand"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1055\/s-2005-870661","article-title":"Timing of umbilical cord separation and neonatal intensive care unit practices","volume":"22","author":"C Aygun","year":"2005","journal-title":"Am J Perinatol"},{"issue":"08","key":"ref7","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1089\/thy.2010.0429","article-title":"Thyroid hormones as modulators of immune activities at the cellular level","volume":"21","author":"P De Vito","year":"2011","journal-title":"Thyroid"},{"issue":"S 01","key":"ref8","first-page":"S88","article-title":"Turkish Neonatal Society guideline on neonatal infections-diagnosis and treatment","volume":"53","author":"M Satar","year":"2018","journal-title":"Turk Pediatri Ars"},{"issue":"09","key":"ref9","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1515\/jpem.2010.145","article-title":"Serum thyroid hormone levels in preterm infants born before 33 weeks of gestation and association of transient hypothyroxinemia with postnatal characteristics","volume":"23","author":"D Dilli","year":"2010","journal-title":"J Pediatr Endocrinol Metab"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1038\/sj.jp.7211027","article-title":"Does umbilical cord care in preterm infants influence cord bacterial colonization or detachment?","volume":"24","author":"K Evens","year":"2004","journal-title":"J Perinatol"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"e0227209","DOI":"10.1371\/journal.pone.0227209","article-title":"Umbilical cord separation time, predictors and healing complications in newborns with dry care","volume":"15","author":"M D L\u00f3pez-Medina","year":"2020","journal-title":"PLoS One"},{"issue":"03","key":"ref12","first-page":"CD001057","article-title":"Topical umbilical cord care at birth","volume":"2004","author":"J Zupan","year":"2004","journal-title":"Cochrane Database Syst Rev"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1179\/146532810X12786388978643","article-title":"Umbilical separation time delayed by alcohol application","volume":"30","author":"W C Hsu","year":"2010","journal-title":"Ann Trop Paediatr"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"e275","DOI":"10.1542\/peds.112.4.e275","article-title":"Umbilical cord care in premature infants: the effect of two different cord-care regimens (salicylic sugar powder vs chlorhexidine) on cord separation time and other outcomes","volume":"112","author":"M Pezzati","year":"2003","journal-title":"Pediatrics"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.jogn.2018.12.004","article-title":"Systematic review of the effect of topical application of human breast milk on early umbilical cord separation","volume":"48","author":"A HP Kirk","year":"2019","journal-title":"J Obstet Gynecol Neonatal Nurs"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/S0140-6736(11)61848-5","article-title":"The effect of cord cleansing with chlorhexidine on neonatal mortality in rural Bangladesh: a community-based, cluster-randomised trial","volume":"379","author":"S E Arifeen","year":"2012","journal-title":"Lancet"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"e20162149","DOI":"10.1542\/peds.2016-2149","article-title":"Umbilical cord care in the newborn infant","volume":"138","author":"D Stewart","year":"2016","journal-title":"Pediatrics"},{"key":"ref18","first-page":"169","article-title":"Alcohol or traditional methods versus natural drying for newborn's cord care","volume":"80","author":"F M Shoaeib","year":"2005","journal-title":"J Egypt Public Health Assoc"},{"issue":"09","key":"ref19","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1111\/j.1440-1754.2009.01555.x","article-title":"Variability in incubator humidity practices in the management of preterm infants","volume":"45","author":"L Sinclair","year":"2009","journal-title":"J Paediatr Child Health"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/S0022-3476(74)80134-4","article-title":"Leukocyte function in normal and infected neonates","volume":"85","author":"D C Anderson","year":"1974","journal-title":"J Pediatr"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"23","DOI":"10.3389\/fped.2017.00023","article-title":"Age-appropriate functions and dysfunctions of the neonatal neutrophil","volume":"5","author":"S M Lawrence","year":"2017","journal-title":"Front Pediatr"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1159\/000243273","article-title":"Umbilical cord separation: histological findings and perinatal factors","volume":"58","author":"A M Oudesluys-Murphy","year":"1990","journal-title":"Biol Neonate"},{"issue":"03","key":"ref23","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1093\/tropej\/fmt003","article-title":"Effect of topical application of chlorhexidine for umbilical cord care in comparison with conventional dry cord care on the risk of neonatal sepsis: a randomized controlled trial","volume":"59","author":"G Gathwala","year":"2013","journal-title":"J Trop Pediatr"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/j.0954-6820.1981.tb09817.x","article-title":"Neutrophil function in hypothyroid patients","volume":"210","author":"J Palmblad","year":"1981","journal-title":"Acta Med Scand"},{"issue":"06","key":"ref25","first-page":"304","article-title":"Functional characterization of peripheral blood neutrophils in patients with primary hypothyroidism","volume":"39","author":"A Hrycek","year":"1993","journal-title":"Folia Biol (Praha)"},{"issue":"02","key":"ref26","doi-asserted-by":"crossref","first-page":"R67","DOI":"10.1530\/JOE-16-0462","article-title":"Thyroid hormone metabolism in innate immune cells","volume":"232","author":"A H van der Spek","year":"2017","journal-title":"J Endocrinol"},{"issue":"05","key":"ref27","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1210\/en.2018-00053","article-title":"Regulation of intracellular triiodothyronine is essential for optimal macrophage function","volume":"159","author":"A H van der Spek","year":"2018","journal-title":"Endocrinology"},{"issue":"01","key":"ref28","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1159\/000243231","article-title":"Separation of the umbilical cord--histological findings","volume":"58","author":"A M Oudesluys-Murphy","year":"1990","journal-title":"Biol Neonate"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1726035.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,22]],"date-time":"2023-10-22T10:33:12Z","timestamp":1697970792000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1726035"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,3]]},"references-count":28,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2022,11,8]]},"published-print":{"date-parts":[[2022,11]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1726035","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,3]]}}}