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Published Online First: 16 February 2007. doi:10.1136/adc.2006.100354
Archives of Disease in Childhood - Fetal and Neonatal Edition 2008;93:F20-F23
Copyright © 2008 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.

ORIGINAL ARTICLES

Delayed cord clamping in preterm infants delivered at 34–36 weeks’ gestation: a randomised controlled trial

C A Ultee1, J van der Deure1, J Swart2, C Lasham3 and A L van Baar4

1 Department of Paediatrics, Deventer Hospital, The Netherlands
2 Wilhelmina Children’s Hospital, Utrecht, The Netherlands
3 Department of Paediatrics, Hospital Gooi-Noord, The Netherlands
4 Paediatric Psychology, Tilburg University, The Netherlands

Correspondence to:
Dr C A Ultee, Department of Paediatrics, Deventer Hospital, Postbus 5001 fesevurstraat, Deventer 7400 GC, The Netherlands; ulteec{at}dz.nl

Background: Even mild iron deficiency and anaemia in infancy may be associated with cognitive deficits. A delay in clamping the cord improves haematocrit levels and results in greater vascular stability and less need for packed cell transfusions for anaemia in the first period after birth. Follow-up data on haemoglobin levels after the neonatal period were not available.

Objective: To provide neonatal and follow-up data for the effects of early or delayed clamping of the cord.

Methods: 37 premature infants (gestational age 34 weeks, 0 days–36 weeks, 6 days) were randomly assigned to one of two groups in the first hour after birth, and at 10 weeks of age. In one group the umbilical cord was clamped within 30 seconds (mean (SD) 13.4 (5.6)) and in the other, it was clamped at 3 minutes after delivery. In the neonatal period blood glucose and haemoglobin levels were determined. At 10 weeks of age haemoglobin and ferritin levels were determined.

Results: The late cord-clamped group showed consistently higher haemoglobin levels than the early cord-clamped group, both at the age of 1 hour (mean (SD) 13.4 (1.9) mmol/l vs 11.1 (1.7) mmol/l), and at 10 weeks (6.7 (0.75) mmol/l vs 6.0 (0.65) mmol/l). No relationship between delayed clamping of the umbilical cord and pathological jaundice or polycythaemia was found.

Conclusion: Immediate clamping of the umbilical cord should be discouraged.


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This article has been cited by other articles:

  • Collard, K. J. (2009). Iron Homeostasis in the Neonate. Pediatrics 123: 1208-1216 [Abstract] [Full Text]  
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eLetters:

Read all eLetters

The Optimal Time to Clamp the Umbilical Cord
George M Morley MD
Fetal Neonatal Ed. Online, 5 Mar 2007 [Full text]
Delayed cord clamping in clinical practice needs more evidence
Dr Egware B Odeka FRCP FRCPCH, et al.
Fetal Neonatal Ed. Online, 19 May 2008 [Full text]

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