Bridging the Gap between Evidence and Practice: A Systematic Review—When Is the Best Time to Clamp the Infant’s Umbilical Cord in Term Low-Risk Women?

Abstract

Historically, in midwifery and obstetric care, the umbilical cord was not usually clamped until all pulsation of the cord had ceased. This is now referred to as delayed cord clamping or DCC (not clamping umbilical cord before two minutes of life). During the last one hundred years with changes in the ways women give birth, especially the shift toward hospital based birth in the Western world, it became commonplace for the cord to be clamped within 20 - 30 seconds of birth (immediate cord clamping or ICC). Authors have postulated various reasons for this shift in timing of umbilical cord clamping to include a possible decreased risk of postpartum hemorrhage, the need for resuscitation of the newborn and sampling of cord blood for stem cells and cord blood analysis. Recent evidence suggests that newborns (particularly in low-resourced settings) would benefit greatly from a policy of DCC with decreased risks of childhood anemia, subsequent sequelae and the need for supplementation. This systematic review examined recent literature from the last eight years using commonly used academic search engines with associated keywords. The results were carefully collated into a table of findings and outcomes.