Evidence favours delayed cord clamping in most newborns, but further studies are needed
Recommendation For pre-term and term infants who do not require respiratory support, it is advisable to delay umbilical cord clamping for at least 60 seconds
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- 1. Perlman JM, Wyllie J, Kattwinkel J, et al. Part 7: neonatal resuscitation — 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation 2015; 132: S204-S241.
- 2. Fogarty M, Osborn DA, Askie L, et al. Delayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-analysis. Am J Obstet Gynecol 2018; 218: 1-18.
- 3. Tarnow-Mordi W, Morris J, Kirby A, et al. Delayed versus immediate cord clamping in preterm infants. N Engl J Med 2017; 377: 2445-2455.
- 4. Popat H, Robledo KP, Sebastian L, et al. Effect of delayed cord clamping on systemic blood flow: a randomized controlled trial. J Pediatr 2016; 178: 81-86.e2.
- 5. Bhatt S, Alison BJ, Wallace EM, et al. Delaying cord clamping until ventilation onset improves cardiovascular function at birth in preterm lambs. J Physiol 2013; 591: 2113-2126.
- 6. Ersdal HL, Linde J, Mduma E, et al. Neonatal outcome following cord clamping after onset of spontaneous respiration. Pediatrics 2014; 134: 265-272.
- 7. Nevill E, Meyer MP. Effect of delayed cord clamping (DCC) on breathing and transition at birth in very preterm infants. Early Hum Dev 2015; 91: 407-411.
- 8. Polglase GR, Dawson JA, Kluckow M, et al. Ventilation onset before umbilical cord clamping (physiological-based cord clamping) improves systemic and cerebral oxygenation in preterm lambs. PLoS One 2015; 10: e0117504.
- 9. Katheria A, Poeltler D, Durham J, et al. Neonatal resuscitation with an intact cord: a randomized clinical trial. J Pediatr 2016; 178: 75-80.e3.
- 10. Wyckoff MH, Aziz K, Escobedo MB, et al. Part 13: neonatal resuscitation — 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2015; 132: S543-S560.
- 11. Sweet DG, Carnielli V, Greisen G, et al. European consensus guidelines on the management of respiratory distress syndrome — 2016 update. Neonatology 2017; 111: 107-125.
- 12. Committee on Obstetric Practice, American College of Obstetricians and Gynecologists. Committee opinion no. 543: timing of umbilical cord clamping after birth. Obstet Gynecol 2012; 120: 1522-1526.
- 13. National Institute for Health and Care Excellence. Preterm labour and birth: NICE guideline (NG25) [website]. London: NICE; 2015. https://www.nice.org.uk/guidance/ng25 (viewed Feb 2018).
- 14. Ersdal HL, Linde J, Auestad B, et al. Timing of cord clamping in relation to start of breathing or ventilation among depressed neonates-an observational study. BJOG 2016; 123: 1370-1377.
- 15. Stark MJ, Hodyl NA, Belegar VKK, Andersen CC. Intrauterine inflammation, cerebral oxygen consumption and susceptibility to early brain injury in very preterm newborns. Arch Dis Child Fetal Neonatal Ed 2016; 101: F137-F142.
- 16. Andersen CC, Pillow JJ, Gill AW, et al. The cerebral critical oxygen threshold of ventilated preterm lambs and the influence of antenatal inflammation. J Appl Physiol 2011; 111: 775-781.
- 17. Sehgal A, Allison BJ, Gwini SM, et al. Vascular aging and cardiac maladaptation in growth-restricted preterm infants. J Perinatol 2018; 38: 92-97.
- 18. Sehgal A, Allison BJ, Gwini SM, et al. Cardiac morphology and function in preterm growth restricted infants: relevance for clinical sequelae. J Pediatr 2017; 188: 128-134.e2
- 19. Polglase GR, Allison BJ, Coia E, et al. Altered cardiovascular function at birth in growth-restricted preterm lambs. Pediatr Res 2016; 80: 538-546.
- 20. Polglase GR, Blank DA, Barton SK, et al. Physiologically based cord clamping stabilises cardiac output and reduces cerebrovascular injury in asphyxiated near-term lambs. Arch Dis Child Fetal Neonatal Ed 2017; https://doi.org/10.1136/archdischild-2017-313657 [Epub ahead of print].
- 21. Katheria AC, Brown MK, Faksh A, et al. Delayed cord clamping in newborns born at term at risk for resuscitation: a feasibility randomized clinical trial. J Pediatr 2017; 187: 313-317.e1.
Online responses are no longer available. Please refer to our instructions for authors page for more information.
This research was supported by a joint National Heart Foundation of Australia and National Health and Medical Research Council Research Fellowship (GRP: 1105526) and by the Victorian Government’s Operational Infrastructure Support Program.
No relevant disclosures.