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Vol. 93, No. 2, 2008
Issue release date: February 2008

A Systematic Review and Meta-Analysis of a Brief Delay in Clamping the Umbilical Cord of Preterm Infants

Rabe H. · Reynolds G. · Diaz-Rossello J.
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Abstract

Background: The optimal timing of clamping the umbilical cord in preterm infants at birth is the subject of continuing debate. Objective: To investigate the effects of a brief delay in cord clamping on the outcome of babies born prematurely. Methods: A retrospective meta-analysis of randomised trials in preterm infants was conducted. Data were collected from published studies identified by a structured literature search in EMBASE, PubMed, CINAHL and the Cochrane Library. All infants born below 37 weeks gestation and enrolled into a randomised study of delayed cord clamping (30 s or more) versus immediate cord clamping (less than 20 s) after birth were included. Systematic search and analysis of the data were done according to the methodology of the Cochrane collaboration. Results: Ten studies describing a total of 454 preterm infants were identified which met the inclusion and assessment criteria. Major benefits of the intervention were higher circulating blood volume during the first 24 h of life, less need for blood transfusions (p = 0.004) and less incidence of intraventricular hemorrhage (p = 0.002). Conclusions: The procedure of a delayed cord clamping time of at least 30 s is safe to use and does not compromise the preterm infant in the initial post-partum adaptation phase.



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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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References

  1. Saigal S, O’Neill A, Surainder Y, Chua LB, Usher R: Placental transfusion and hyperbilirubinemia in the premature. Pediatrics 1972;49:406–419.
  2. Yao AC, Lind J: Placental transfusion. Am J Dis Child 1974;127:128–141.
  3. Brune T, Garritsen H, Witteler R, Schlake A, Wüllenweber J, Louwen F, Jorch G, Harms E: Autologous placental blood transfusion for the therapy of anemic neonates. Biol Neonat 2002;81:236–243.

    External Resources

  4. Yanowitz TD, Yao AC, Pettigrew KD, Werner JC, Oh W, Stonestreet BS: Postnatal hemodynamic changes in very-low-birthweight infants. J Appl Physiol 1999;87:370–380.
  5. Watkins AMC, West CR, Cooke RWI: Blood pressure and cerebral haemorrhage and ischaemia in very low birth weight infants. Early Hum Dev 1989;19:103–110.
  6. Evans N, Kluckow M: Early ductal shunting and intraventricular haemorrhage in ventilated preterm infants. Arch Dis Child 1996;75:F183–F186.
  7. Rabe H, Reynolds G, Diaz-Rossello J: Early versus delayed umbilical cord clamping in preterm infants.Cochrane Database Syst Rev 2004, Issue 4, Art No CD003248.
  8. Clarke M, Oxman AD (eds): Cochrane Reviewers’ Handbook 4.0. Oxford, The Cochrane Collaboration, 1999.
  9. Frank DJ, Gabriel M: Timing of cord ligation and newborn respiratory distress. Am J Obstet Gynecol 1967;97:1142–1144.
  10. Ibrahim HM, Krouskop RW, Lewis DF, Dhanireddy R: Placental transfusion: umbilical cord clamping in preterm infants. J Perinatol 2000;120:351–354.

    External Resources

  11. Narendra A, Beckett C, Aitchinson T, Kyle E, Coutts J, Turner T: Is it possible to promote placental transfusion (PTFx) at preterm delivery? Pediatr Res 1998;44:454A.

    External Resources

  12. Saigal S, Usher RH: Symptomatic neonatal plethora. Biol Neonat 1977;32:62–72.
  13. Spears RL, Anderson GV, Brotman S, Farrier J, Kwan J, Masto A, Perrin L, Stebbins R: The effect of early versus late cord clamping on signs of respiratory distress. Am J Obstet Gynecol 1966;95:564–568.
  14. Strauss RG, Mock MM, Johnson K, Mock NI, Cress G, Knosp L, Lobas L, Schmidt RL: Circulating RBC volume, measured with biotinylated RBCs, is superior to the Hct to document the hematologic effects of delayed versus immediate umbilical cord clamping in preterm neonates. Transfusion 2003;43:1168–1172.
  15. Taylor P, Bright N, Birchard E: Effect of early versus delayed clamping of the umbilical cord on the clinical condition of the newborn infant. Am J Obstet Gynecol 1963;86:893–898.
  16. Hofmeyr GJ, Bolton KD, Bowen DC, Govan JJ: Periventricular/intraventricular haemorrhage and umbilical cord clamping. S Afr Med J 1988;73:104–106.
  17. Hofmeyr GJ, Gobetz L, Bex PJM, Van Der Griendt M, Nikodem CV, Skapinker R: Periventricular/intraventricular hemorrhage following early and delayed umbilical cord clamping: a randomized trial. Online J Curr Clin Trials 1993, Doc No 110.
  18. Kinmond S, Aitchison TC, Holland BM, Jones JG, Turner TL, Wardrop CAJ: Umbilical cord clamping and preterm infants: a randomised trial. BMJ 1993;306:172–175.
  19. McDonnell M, Henderson Smart DJ: Delayed umbilical cord clamping in preterm infants: a feasibility study. J Paediatr Child Health 1997;33:308–310.
  20. Nelle M, Fischer S, Conze S, Beedgen B, Grischke EM, Linderkamp O: Effects of late cord clamping on circulation in prematures (VLBWI). Pediatr Res 1998;44:454.

    External Resources

  21. Rabe H, Wacker A, Hulskamp G, Hornig-Franz I, Schulze-Everding A, Harms E, Cirkel U, Louwen F, Witteler R, Schneider HP: A randomised controlled trial of delayed cord clamping in very low birth weight preterm infants. Eur J Pediatr 2000;159:775–777.
  22. Oh W, Carlo WA, Fanaroff AA, McDonald S, Donovan EF, Poole K: Delayed cord clamping in extremely low birth weight infants – a pilot randomised controlled trial. Pediatr Res 2002;51:365–366.
  23. Mercer JS, McGrath MM, Hensman A, Silver H, Oh W: Immediate and delayed cord clamping in infants born between 24 and 32 weeks: a pilot randomized controlled trial. J Perinatol 2003;23:466–472.
  24. Mercer JS, Vohr BR, McGrath M, Padbury JF, Wallach M, Oh W: Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage (IVH) and late onset sepsis (LOS). Pediatric Academic Societies Annual Meeting, Washington, PAS 2005, vol 57, p 2618.
  25. Aladangady N, Aitchinson TC, Holland M, Wardrop CAJ: Infant’s blood volume in a controlled trial of placental transfusion at preterm delivery. Pediatrics 2006;117:93–98.


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