Delayed Versus Immediate Umbilical Cord Clamping

Shanterra Grable, Mercer University College of Pharmacy

Delayed umbilical cord clamping is performed from 25 seconds to five minutes after birth. The practice is thought to allow more blood to transfer from the placenta to the newborn, possibly increasing the baby’s blood volume by 30%. The American Congress of Obstetricians and Gynecologists (ACOG) supports delayed cord clamping in preterm infants but not in full term infants due to insufficient evidence showing benefits. The current standard during delivery  is to clamp the umbilical cord 10 to 30 seconds immediately after birth.  [1]

One of the associated benefits of delayed clamping is decreased risk of iron deficiency anemia due to transfer of additional 40 to 50 mg/kg of iron from the placenta to the infant. [1] Prior randomized controlled trials found that delayed cord clamping in preterm infants less than 32 weeks gestational age had lower instances of mortality, necrotizing enterocolitis, and infection than infants with immediate cord clamping; however, these studies did not show if delayed cord clamping is the sole factor leading to mortality and neurodevelopmental benefits. Despite the potential benefits, delayed clamping is not a universal practice due to concerns of delayed resuscitation and hyperbilirubinemia.  The following study was performed to add knowledge regarding the effects of delayed clamping on death and major morbidity in preterm infants. [2]

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