Delayed Cord Clamping in Preterm Infants

Abstract

During the 1960s and 1970s, there were multiple studies of the effects on the neonate of varying the time of umbilical cord clamping. Interest in this area of investigation lay dormant for ∼15 years, but in the past decade there has been renewed investigation of this topic, particularly in the preterm infant. In a recent article, Dr Saroj Saigal and I reviewed the history and implications of early and late umbilical cord clamping in both term and preterm infants,1 noting that definitions have varied widely over the years. More than a century ago, “early” was sometimes considered to be within 1 minute, whereas “late” may have been after 5 minutes. Currently, “early” is generally defined as “immediate,” which may take up to 15 seconds, and “late” as 45 to 60 seconds after delivery of the body, by which time the majority of available blood in the placenta will have been transferred to the infant in the form of a “placental transfusion.” In our article we suggested that lack of interest in the timing of umbilical cord clamping in preterm infants might have been a result of the introduction of surfactant as therapy for respiratory distress syndrome (RDS).1 A recent Cochrane review also evaluated the effects of different times of umbilical cord clamping in preterm infants.2 In an earlier era, the possibility that RDS (also … Address correspondence to Alistair G.S. Philip, MD, FRCPE, Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, 750 Welch Rd, Palo Alto, CA 94304. E-mail: aphilip{at}stanford.edu