November 17, 2023: A recent study suggests that delaying the clamping of the umbilical cord for premature babies may decrease the risk of death by 50 percent.
Researchers say that waiting just a few extra minutes before clamping the cord can significantly increase the chances of survival for premature infants.
Delayed cord clamping
The study demonstrates a notable decrease in neonatal mortality with delayed cord clamping. The advantages of the practice include the infusion of extra blood from the placenta for the infant and how the intervention may lessen the need for blood support and transfusions.
Another advantage of delayed clamping is the transfusion of iron through the placenta which helps in overcooking this deficiency, which causes anemia.
Differing clamping time practices
While the recommended duration for delayed cord clamping varies among organizations, the study suggests that a longer delay, specifically around 2 minutes, may yield the best risk reduction.
Generally, cord clamping is carried out in the first 60 seconds after birth, whereas “delayed” umbilical cord clamping is carried out more than 1 minute after birth or when cord pulsation has ceased.
The optimal timing of umbilical cord clamping has been drawn up as part of perinatal care guidelines for both the mother and neonate. Postpartum haemorrhage (defined as a blood loss of 500 mL or more within 24 hours after birth) affects approximately 2% of all women who give birth and is responsible for nearly 25% of maternal deaths worldwide. In low-income countries, postpartum haemorrhage can lead to long-term ill health and disabilities.
It is believed that early cord clamping leads to a reduced risk of postpartum haemorrhage. But with new research on the benefits of delayed clamping, analysis of the timing of umbilical cord clamping in relation to postpartum haemorrhage is considered important.
Experts and doctors emphasize the importance of individualized assessments and considerations for immediate resuscitation. About one quarter of all neonatal deaths globally are caused by birth asphyxia. Effective resuscitation at birth can prevent a large proportion of these deaths. However, there are certain constraints to providing effective resuscitation without cord-cutting. The need for clinical guidelines on basic neonatal resuscitation, suitable for settings with limited resources, is the need of the hour, according to experts.
Beyond cord clamping, the present study delves into other factors contributing to premature infant mortality, such as respiratory health, blood pressure, and gestational age. Experts underscore the need for further research in low-resource settings to ensure the applicability of these findings globally.
Implementing change in neonatal care
The study’s first author, Dr. Anna Lene Seidler, highlights the potential for this intervention to be a game-changer, particularly in low-resource settings.
The findings call for a global shift in clinical guidelines, paving the way for a safer and healthier start for the most vulnerable newborns.