Monday, April 25, 2016

Update: New Findings on Delayed Cord Clamping

Several new studies demonstrate the benefits of delayed cord clamping in infants, particularly preterm infants.

A study in the Journal of Maternal-fetal and neonatal medicine: the official journal of the European Association of Perinatal Medicine the Federation of Asia and Oceania Perinatal Societies and the International Society of Perinatal Obstetricians, states that after implementation of a delayed cord clamping (DCC) policy, preterm singleton infants had improved temperatures, increased hematocrits and decrease in the prevalence of intraventricular hemorrhage without significant adverse outcomes.

Jelin, A.C. et al. (2016) Clamp late and maintain perfusion (CLAMP) policy: delayed cord clamping in preterm infants. Journal of Maternal-Fetal and Neonatal Medicine.  29(11): 1705-9.

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An interesting study from Advances in Neonatal Care: the official journal of the National Association of Neonatal Nurses tells us that DCC was the mainstay practice until the 1950s when a few studies suggested that it might interfere with active management of the third stage of labor. 

Bayer, K. (2016) Delayed Umbilical Cord Clamping in the 21st Century: Indications for practice. Advances in Neonatal Care. 16(1): 68-73.

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A study published in  Transfusion states that DCC greatly diminishes volume and thus impedes the mount of blood collectable for cord blood banking.

Alan, D.S. (2016) Delayed clamping of the umbilical cord after delivery and implications for public cord blood banking. Transfusion  56(3): 662-5.

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ACOG has not updated their Practice Bulletin/Opinion since 2014, however, they do state that a delay in umbilical cord clamping for up to 60 seconds may increase total body iron stores and blood volume in all infants .  In preterm infants, benefits include improved transitional circulation, better establishment of RBC volume and decreased need for blood transfusion.

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There is a nice website called Delayed Cord Clamping with some updates through 2015 of evidence based articles:

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And here is a nice overview of a study that followed children years later after DCC:

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