A systematic review and meta-analysis of a brief delay in clamping the umbilical cord of preterm infants

Neonatology. 2008;93(2):138-44. doi: 10.1159/000108764. Epub 2007 Sep 21.

Abstract

Background: The optimal timing of clamping the umbilical cord in preterm infants at birth is the subject of continuing debate.

Objective: To investigate the effects of a brief delay in cord clamping on the outcome of babies born prematurely.

Methods: A retrospective meta-analysis of randomised trials in preterm infants was conducted. Data were collected from published studies identified by a structured literature search in EMBASE, PubMed, CINAHL and the Cochrane Library. All infants born below 37 weeks gestation and enrolled into a randomised study of delayed cord clamping (30 s or more) versus immediate cord clamping (less than 20 s) after birth were included. Systematic search and analysis of the data were done according to the methodology of the Cochrane collaboration.

Results: Ten studies describing a total of 454 preterm infants were identified which met the inclusion and assessment criteria. Major benefits of the intervention were higher circulating blood volume during the first 24 h of life, less need for blood transfusions (p = 0.004) and less incidence of intraventricular hemorrhage (p = 0.002).

Conclusions: The procedure of a delayed cord clamping time of at least 30 s is safe to use and does not compromise the preterm infant in the initial post-partum adaptation phase.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Blood Volume / physiology
  • Constriction
  • Delivery, Obstetric / methods*
  • Humans
  • Infant, Newborn
  • Infant, Premature / physiology*
  • Time Factors
  • Umbilical Cord / physiology*