Benefits of Delayed Cord Clamping at Birth

2013-09-30 08:31:48

The past few years has seen an increase in requests by expectant mothers for delayed cord clamping at birth. Delayed clamping refers to waiting at least 2-3 minutes, or until cord pulsation has ceased, after birth before clamping and cutting the umbilical cord, whereas early clamping is done within the first minute. Although research accumulating over the past decade shows this delay has significant health benefits for the baby, many maternity wards still routinely clamp and cut immediately after the baby is born. A Cochrane Systematic Review is putting this practice into question, comparing the effects of early versus late cord clamping on both mother and baby.⁽¹⁾ They included fifteen trails that involved nearly 4000 women and their newborns. No effect was found in the women however benefit to the newborn was substantial, including higher birth weight, higher initial hemoglobin concentrations and most importantly increased iron storage that persisted for up to six months after birth. A delay of at least 2 minutes allows between 20-40mls of additional blood to pass form the placenta to the newborn, providing roughly 30-35mg of iron.⁽²⁾ These benefits appear even more important for preterm infants, benefiting not only blood parameters but also reducing the need for blood transfusion during the first 6 weeks of life^{(3, 4)} Delayed clamping in preterm deliveries, including caesareans, is feasible unless the baby is in distress and should be encouraged when possible.⁽⁴⁾ Although the Cochrane review indicates that delayed cord clamping may increase the risk of neonatal jaundice and need for phototherapy, other research does not support this.^{(2, 5)} From the mounting evidence, it is becoming clear that a shift in practice guidelines is needed in order to afford these health benefits to more infants.