Knowledge gaps in optimal umbilical cord management at birth

Heike Rabe; Judith Mercer

doi:10.1016/j.semperi.2023.151791

Knowledge gaps in optimal umbilical cord management at birth

Semin Perinatol. 2023 Aug;47(5):151791. doi: 10.1016/j.semperi.2023.151791. Epub 2023 Jun 11.

Authors

Heike Rabe¹, Judith Mercer²

Affiliations

¹ Academic Department of Paediatrics, Brighton and Sussex Medical School, University of Sussex, UK. Electronic address: Heike.Rabe@nhs.net.
² Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego CA, USA; College of Nursing, University of Rhode Island, Kingston RI, USA.

PMID: 37357042
DOI: 10.1016/j.semperi.2023.151791

Abstract

In 2014 the World Health Organisation recommended providing placental blood to all newborn infants by waiting for at least one minute before clamping the umbilical cord. Mounting evidence supports providing a placental transfusion at the time of birth for all infants. The optimal time before clamping and cutting the umbilical cord is still not yet known, and debate exists around other cord management issues. The newborn's transition phase from intra- to extra-uterine life and the effects of blood volume on the many necessary adaptations are understudied. How best to support these adaptations guides our suggested research questions. Parents' perceptions of enrolling their unborn infant into a study play important parts in the conduct of such trials. This article aims to address these topics and suggest research questions for further studies.

Keywords: Autonomic nervous system; Birth; Knowledge gap; Newborn; Umbilical cord.

MeSH terms

Blood Transfusion
Female
Humans
Infant, Newborn
Infant, Premature*
Parturition
Placenta*
Pregnancy
Umbilical Cord