Delayed Cord Clamping by Two Minutes Results in Better Immediate Newborn Outcomes

Umbilical Cord ClampingDuring the births of both my children, I opted for delayed cord clamping and cutting. Although current birthing practices include severing the umbilical cord early, a new study published in the journal Pediatrics concludes that delayed cord clamping by two minutes results in better development for the newborn during the first days of life.

Since the 1950s, early clamping has been defined as clamping the umbilical cord before sixty seconds after birth and late clamping as more than five minutes after birth. Because of a series of studies determined that more than 90 percent of blood volume was achieved in a newborn within the first few breaths combined with a lack of recommendations for the optimal clamping interval, the time between birth and cord clamping began to shorten in the middle of the last century.

The World Health Organization (WHO) currently recommends late cord clamping (one to three minutes after birth) unless the newborn requires resuscitation. The American Congress of Obstetricians and Gynecologists (ACOG) states that the ideal timing for umbilical cord clamping has not yet been established.

Reasons for delayed cord clamping include better blood counts and iron levels for the newborn.

For the present study, researchers led by Professor Julio José Ochoa Herrera of the University of Granada assessed the outcomes of newborns born to 64 healthy pregnant women to determine the influence of early and late cord clamping in correlation with oxidative stress and inflammation signaling.

All the women in the study had normal pregnancies and spontaneous vaginal deliveries. Half the participants experienced early cord clamping within ten seconds after birth while the other half experienced delayed cord clamping of two minutes.

According to the study, delayed clamping by two minutes produced by an increase in antioxidant capacity and moderation of the inflammatory-mediated effects induced during birth.

Comments Dr. Ochoa:

“Our study demonstrates that late clamping of the umbilical cord has a beneficial effect upon the antioxidant capacity and reduces the inflammatory signal induced during labor, which could improve the development of the newborn during his or her first days of life.”

Despite evidence of the benefits of delayed clamping, ACOG states that universal adoption of the practice has been questioned because of concerns about jeopardizing timely resuscitation efforts, especially among premature newborns, adding, “However, because the placenta continues to perform gas exchange after delivery, sick and preterm infants are likely to benefit most from additional blood volume derived from a delay in umbilical cord clamping.”

Another concern is an increased risk of excessive placental transfusion, which can lead to neonatal polycythemia, especially in the presence of risk factors such as maternal diabetes, severe intrauterine growth restriction, and high altitude.

Nevertheless, the WHO continues to recommend against cord clamping before sixty seconds except in the case that the newborn requires removal from the mother for resuscitation. Additionally, the WHO argues that delayed clamping “may be particularly relevant for infants living in low-resource settings with reduced access to iron-rich foods.”

Another recent study from July 2013 as published in the Cochrane Database of Systematic Reviews also found that delayed cord clamping results in healthier blood and iron levels in babies.


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The timing of cord clamping and oxidative stress in term newborns:
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A two-minute delay in cutting the umbilical cord leads to a better developent of newborns during their first days of life:

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