Neonatal transitional physiology: a new paradigm

J Perinat Neonatal Nurs. 2002 Mar;15(4):56-75. doi: 10.1097/00005237-200203000-00007.


Early clamping of the umbilical cord at birth, a practice developed without adequate evidence, causes neonatal blood volume to vary 25% to 40%. Such a massive change occurs at no other time in one's life without serious consequences, even death. Early cord clamping may impede a successful transition and contribute to hypovolemic and hypoxic damage in vulnerable newborns. The authors present a model for neonatal transition based on and driven by adequate blood volume rather than by respiratory effort to demonstrate how neonatal transition most likely occurs at a normal physiologic birth.

Publication types

  • Review

MeSH terms

  • Delivery, Obstetric / methods*
  • Erythrocytes / physiology
  • Female
  • Fetal Blood / physiology*
  • Humans
  • Infant, Newborn / physiology*
  • Models, Cardiovascular*
  • Placental Circulation / physiology
  • Pregnancy
  • Respiration
  • Time Factors
  • Umbilical Cord / blood supply*