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umbilical cord clamping

Clinical significance: - delaying clamping of umbilical cord (3 minutes or more rather than 10 seconds after birth) allows placental transfusion which increases to total blood volume by almost 1.3; at 4 months of age delayed clamping increases serum ferritin (117 vs 81 ug/L) & lowers prevalence of iron deficiency (0.6% vs 5.7%); blood hemoglobin levels at 4 months are unchanged by delayed clamping [1] - phototherapy for jaundice is less common with early clamping of umbilical cord (< 60 seconds) (RR = 0.62) - delayed umbilical cord clamping is associated with better fine motor & social skills at preschool age among boys [3] - no difference in IQ score - benefits of delayed clamping limited to boys [3]* - ACOG recommends delayed umbilical cord clamping for least 30-60 seconds after birth for healthy term & preterm infants [4] * male infants apparently at increased risk for iron deficiency relative to girls [3]

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umbilical cord

General

clinical procedure

References

  1. Andersson O et al Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomised controlled trial BMJ 2011;343:bmj.d7157 PMID: 22089242 http://www.bmj.com/content/343/bmj.d7157 - van Rheenen P Delayed cord clamping and improved infant outcomes BMJ 2011;343:bmj.d7127 PMID: 22089240 http://www.bmj.com/content/343/bmj.d7127
  2. McDonald SJ et al Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database Syst Rev. 2013 Jul 11;7:CD004074 PMID: 23843134 http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004074.pub3/abstract
  3. Andersson O et al Effect of Delayed Cord Clamping on Neurodevelopment at 4 Years of Age. A Randomized Clinical Trial. JAMA Pediatr. Published online May 26, 2015. PMID: 26010418 http://archpedi.jamanetwork.com/article.aspx?articleid=2296145 - Rabe H et al Long-term Follow-up of Placental Transfusion in Full-term Infants. JAMA Pediatr. Published online May 26, 2015 PMID: 26010324 http://archpedi.jamanetwork.com/article.aspx?articleid=2296144
  4. American College of Obstetricians and Gynecologists' Committee on Obstetric Practice. Delayed Umbilical Cord Clamping After Birth Committee Opinion. Number 684, January 2017 http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Delayed-Umbilical-Cord-Clamping-After-Birth