Delayed cord clamping (DCC) is a practice endorsed by multiple international organizations for its benefits in improving neonatal hematologic status and iron stores. However, most existing literature is focused on low-risk deliveries, with limited data on its applicability and safety in neonates born to mothers with comorbidities such as hypertension, diabetes mellitus, hypothyroidism, and anemia. These conditions are common in pregnancy and potentially alter fetal physiology and placental perfusion, thereby influencing the outcomes of placental transfusion.

This randomized controlled trial aims to evaluate the clinical and hematological effects of two different timings of DCC between 30 to 60 seconds versus more than 60 seconds on neonates born at more than 34 weeks of gestation to mothers with predefined comorbidities. Primary outcomes include neonatal hematocrit ,incidence of polycythemia, assess hyperbilirubinemia, phototherapy requirements, hypoglycemia, and persistent tachypnea. The results will help inform evidence-based guidelines for optimal cord clamping timing in this high-risk population.