Effects of delayed cord clamping on residual placental blood volume, hemoglobin and bilirubin levels in term infants: a randomized controlled trial

J Perinatol. 2017 Mar;37(3):260-264. doi: 10.1038/jp.2016.222. Epub 2016 Dec 8.


Objective: The objective of the study was to measure the effects of a 5-min delay (DCC) versus immediate cord clamping (ICC) on residual placental blood volume (RPBV) at birth, and hemoglobin and serum bilirubin at 24 to 48 h of age.

Study design: In this prospective randomized controlled trial, 73 women with term (37 to 41 weeks) singleton fetuses were randomized to DCC (⩾5 min; n=37) or ICC (<20 s; n=36).

Results: Maternal and infant demographics were not different between the groups. Mean cord clamping time was 303±121 (DCC) versus 23±59 (ICC) s (P<0.001) with 10 protocol violations. Cord milking was the proxy for DCC (n=11) when the provider could not wait. Infants randomized to DCC compared with ICC had significantly less RPBV (20.0 versus 30.8 ml kg-1, P<0.001), higher hemoglobin levels (19.4 versus 17.8 g dl-1, P=0.002) at 24 to 48 h, with no difference in bilirubin levels.

Conclusion: Term infants had early hematological advantage of DCC without increases in hyperbilirubinemia or symptomatic polycythemia.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bilirubin / blood*
  • Blood Volume
  • Constriction
  • Delivery, Obstetric / methods
  • Female
  • Hematocrit
  • Hemoglobins / analysis*
  • Humans
  • Infant, Newborn
  • Male
  • Placenta / blood supply
  • Placental Circulation*
  • Pregnancy
  • Prospective Studies
  • Rhode Island
  • Term Birth / blood*
  • Time Factors
  • Umbilical Cord / blood supply*
  • Young Adult


  • Hemoglobins
  • Bilirubin