Delayed umbilical cord clamping – benefits and risks

Česká verzia

Authors: Tomáš Fait ^1,2 ; J. Janota ¹
Authors place of work: Gynekologicko-porodnická klinika 2. LF UK a FN Motol, Praha ¹; Katedra zdravotnických studií, VŠP Jihlava ²
Published in the journal: Ceska Gynekol 2022; 87(6): 424-426
Category: Review Article
doi: https://doi.org/10.48095/cccg2022424

Summary

Delayed umbilical cord clamping is a standard procedure for active management of the 3^rd stage of labour. There are benefits associated with more than a 30 second delay, but 1 minute is usually recommended. For newborns, increased iron reserves are important having a positive impact on further development. A reduction in the risk of necrotizing enterocolitis and intraventricular hemorrhage is often reported in preterm births. In delayed umbilical cord clamping, no increased maternal blood loss was recorded, even in multiple pregnancies and caesarean sections.

Keywords:

Postpartum hemorrhage – delayed umbilical cord clamping – milking – intraventricular hemorrhage

Zdroje

1. Vain NE, Satragno DS, Gorenstein AN et al. Effect of gravity on volume placental transfusion: a multicentre, randomised, non-inferiority trial. Lancet 2014; 384 (9938): 235–240. doi: 10.1016/S0140-6736 (14) 60197-5.

2. Alistair AG, Saroj S. When should we clamp the umbilical cord? Neoreview 2004; 5 (4): e142–e154: doi: 10.1542/neo.5-4-e142.

3. Linderkamp O, Nelle M, Kraus M et al. The effect of early and late cord-clamping on blood viscosity and other hemorheological parameters in full-term neonates. Acta Paediatr 1992; 81 (10): 745–750. doi: 10.1111/j.1651-2227.1992.tb12095.x.

4. Andersson O, Lindquist B, Lindgren M et al. Effect of delayed cord clamping on neurodevelopment at 4 years of age: a randomized clinical trial. JAMA Pediatr 2015; 169 (7): 631–638. doi: 10.1001/jamapediatrics.2015.0358.

5. Sanberg PR, Divers R, Mehindru A et al. Delayed umbilical cord blood clamping: first line of defense against neonatal and age-related disorders. Wulfenia 2014; 21 (6): 243–249.

6. Al-Wassia H, Shah PS. Efficacy and safety of umbilical cord milking at birth: a systemic review and meta-analysis. JAMA Pediatr 2015; 169 (1): 18–25. doi: 10.1001/jamapediatrics.2014.1906.

7. Allan DS, Scrivens N, Lawless T et al. Delayed clamping of the umbilical cord after delivery and implication for public cord blood banking. Transfusion 2016; 56 (3): 662–665. doi: 10.1111/trf.13424.

8. McDonald SJ, Middleton P, Dowswell T et al. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database Syst Rev 2013; 2013 (7): CD004074. doi: 10.1002/14651858.CD004074.pub3.

9. Rabe H, Diaz-Rossello JL, Duley L et al. Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion et preterm birth on maternal and infant outcomes. Cochrane Database Syst Rev 2012; 8: CD003248. doi: 10.1002/14651858.CD003248.pub3.

10. Katheria A, Reister F, Essers J et al. Association of umbilical cord milking vs delayed umbilical cord clamping with death or severe intraventricular hemorrgage among preterm infants. JAMA 2019; 322 (19): 1877–1876. doi: 10.1001/jama.2019.16004.

11. Fogarty M, Osborn DA, Askie L et al. Delayed vs early umbilical cord clamping for preterm infants: a systematic review and mata-analysis. Am J Obstet Gynecol 2018; 218 (1): 1–18. doi: 10.1016/j.ajog.2017.10.23.

12. Chantry CJ, Blanton A, Taché V et al. Delayed cord clamping during elective cesarean deliveries: result of a pilot safety trial. Matern Health Neonatol Perinatol 2018; 4: 16. doi: 10.1186/s40748-018-0083-3.

13. Ruangkit C, Leon M, Hassen K et al. Maternal bleeding complications following early versus delayed umbilical cord clamping in multiple pregnancies. BMC Pregnancy Childbirth 2018; 18 (1): 131. doi: 10.1186/s12884-018-1781-6.

14. Cavallin F, Baleazzo B, Loretelli V et al. Delayed cord clamping versus early cord clamping in elective cesarean section: a randomized controlled trial. Neonatology 2019; 116 (3): 252–259. doi: 10.1159/000500325.

15. Committee opinion no. 684: delayed umbilical cord clamping after births. Obstet Gynecol 2017; 129 (1): 1. doi: 10.1097/AOG.00000 00000001860.

16. Peberdy L, Young J, Massey D et al. Integrated review of the knowledge, attitudes nad practices of maternity health care professionals concerning umbilical cord clamping. Birth 2022. doi: 10.1111/birt.12647. Online ahead of print.