Delayed cord clamping and haemoglobin levels in infancy: a randomised controlled trial in term babies

Trop Med Int Health. 2007 May;12(5):603-16. doi: 10.1111/j.1365-3156.2007.01835.x.


Objectives: This study was carried out to assess whether delaying umbilical cord clamping is effective in improving the haematological status of term infants living in a malaria-endemic area, and whether this is associated with complications in infants and mothers.

Methods: We randomly assigned women delivering term babies in Mpongwe Mission Hospital, Zambia, to delayed cord clamping (DCC, n = 46) or immediate cord clamping (controls, n = 45) and followed their infants on a bi-monthly basis until the age of 6 months. We compared the haemoglobin (Hb) change from cord values and the proportion of anaemic infants. Secondary outcomes related to infant and maternal safety.

Results: Throughout the observation period infant Hb levels in both groups declined, but more rapidly in controls than in the DCC group [difference in Hb change from baseline at 4 months 1.1 g/dl, 95% confidence interval (CI) 0.2; 2.1]. By 6 months, this difference had disappeared (0.0 g/dl, 95% CI -0.9; 0.8). The odds ratio for iron deficiency anaemia in the DCC group at 4 months was 0.3 (95% CI 0.1; 1.0), but no differences were found between the groups at 6 months. No adverse events were seen in infants and mothers.

Conclusion: Our findings indicate that DCC could help improve the haematological status of term infants living in a malaria-endemic region at 4 months of age. However, the beneficial haematological effect disappeared by 6 months. This simple, free and safe delivery procedure might offer a strategy to reduce early infant anaemia risk, when other interventions are not yet feasible.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anemia / epidemiology
  • Anemia / prevention & control*
  • Constriction
  • Delivery, Obstetric / methods
  • Endemic Diseases
  • Female
  • Fetal Blood / metabolism
  • Hematocrit
  • Hemoglobins / analysis*
  • Humans
  • Infant
  • Infant Food
  • Infant, Newborn
  • Malaria / blood
  • Malaria / epidemiology*
  • Male
  • Obstetric Labor Complications / epidemiology
  • Pregnancy
  • Rural Health
  • Time Factors
  • Umbilical Cord*


  • Hemoglobins