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Delayed Cord Clamping

Cochrane Review – Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes 2009

Cochrane Review – Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes 2009

The full review report, (plus responses critical of the inclusion of infants requiring phototherapy for jaundice as a significant finding) click here for PDF: cochrane review early vs late cord clamping review with responses

Background

Policies for timing of cord clamping vary, with early cord clamping generally carried out in the first 60 seconds after birth, whereas later cord clamping usually involves clamping the umbilical cord greater than one minute after the birth or when cord pulsation has ceased.

Objectives

To determine the effects of different policies of timing of cord clamping at delivery of the placenta on maternal and neonatal outcomes.

Search strategy

We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (December 2007).

Selection criteria

Randomised controlled trials comparing early and late cord clamping.

Data collection and analysis

Two review authors independently assessed trial eligibility and quality and extracted data.

Main results

We included 11 trials of 2989 mothers and their babies. No significant differences between early and late cord clamping were seen for postpartum haemorrhage or severe postpartum haemorrhage in any of the five trials (2236 women) which measured this outcome (relative risk (RR) for postpartum haemorrhage 500 mls or more 1.22, 95% confidence interval (CI) 0.96 to 1.55). For neonatal outcomes, our review showed both benefits and harms for late cord clamping. Following birth, there was a significant increase in infants needing phototherapy for jaundice (RR 0.59, 95% CI 0.38 to 0.92; five trials of 1762 infants) in the late compared with early clamping group. This was accompanied by significant increases in newborn haemoglobin levels in the late cord clamping group compared with early cord clamping (weighted mean difference 2.17 g/dL; 95%CI 0.28 to 4.06; three trials of 671 infants), although this effect did not persist past six months. Infant ferritin levels remained higher in the late clamping group than the early clamping group at six months.

McDonald SJ, Middleton P. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD004074. DOI:10.1002/14651858.CD004074.pub2.

 

 

About Kate Emerson

Kate Emerson, BA (sociology/politics) Kate is a clinical student pursuing her interest in neonatal transitional physiology and clinical cord clamping practices. She produces media to increase the level of awareness about delayed cord clamping for parents, students and interested practitioners. Please visit www.cord-clamping.com to read more.

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