Umbilical cord at birth: are we clamping at the right time?

Posted on July 11, 2013

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Professor McDonald: increased blood and iron levels and better birthweight

A study led by La Trobe University reviewing 15 international trials involving nearly 4,000 women and their babies has found that delayed clamping of the umbilical cord after birth benefits newborn babies.

Lead author Professor of Midwifery Susan McDonald, from La Trobe’s Faculty of Health Sciences and the Mercy Hospital for Women, said the review found babies’ blood and iron levels were increased when the cord was clamped later.

The review said that in many high-income countries, it was standard practice to clamp the umbilical cord connecting mother and baby less than a minute after birth.

The findings were published by the Cochrane Collaboration, widely regarded as the world’s leading independent provider of systematic health reviews.

‘However, clamping the cord too soon may reduce the amount of blood that passes from mother to baby via the placenta, affecting the baby’s iron stores,’ the review said.

On the other hand, it noted that delayed cord clamping, which is carried out more than a minute after birth, may also slightly increase the risk of jaundice, which is treated by light therapy.

Healthier babies

‘The benefits of delayed cord clamping needed to be weighed against this small additional risk of jaundice in newborns,’ the review said. Professor McDonald said the review supports the World Health Organization recommendation of cord clamping between one and three minutes after birth.

The researchers looked at outcomes for mothers and babies separately, and at haemoglobin concentrations as an indicator of healthy blood and iron levels.

‘While clamping the cord later made no difference to the risk of maternal haemorrhaging, blood loss or haemoglobin levels,’ the review said, ‘babies were healthier in a number of respects.’

Delayed clamping meant babies had higher haemoglobin levels between one and two days after birth and were less likely to be iron-deficient three to six months after birth. Their birth weight was also higher with delayed cord clamping.

NOTE: The review focused on the effects of delayed cord clamping when babies were born at full term. Another recent Cochrane review suggested that there might also be health benefits associated with later cord clamping in babies born preterm.

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See also today’s report in New York Times

  • The review’s authors are Susan J McDonald (Midwifery Professorial Unit, La Trobe University/Mercy Hospital for Women, Melbourne, Australia); Philippa Middleton, (ARCH: Australian Research Centre for Health of Women and Babies, The Robinson Institute, Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, Australia); Therese Dowswell, (Cochrane Pregnancy and Childbirth Group, Department of Women’s and Children’s Health, The University of Liverpool, Liverpool, UK); and Peter S Morris, (Division of Child Health, Menzies School of Health Research, Darwin, Australia).