Delayed Cord Clamping Prevalence Among US Hospitals

Abstract

ObjectivesDelayed cord clamping (DCC) allows transfusion of placental blood to a newborn after birth and is recommended by the American College of Obstetricians and Gynecologists. DCC can increase hemoglobin levels and iron stores in term infants, preventing or delaying iron deficiency in young children. This study describes the prevalence of DCC in US hospitals overall and by facility characteristics. MethodsThe 2018 Maternity Practices in Infant Nutrition and Care survey is a census of US hospitals providing maternity care and assesses hospitals’ practices, including “How many healthy newborns at your hospital have their umbilical cord clamped more than one minute after birth?” We estimated the prevalence of hospitals reporting that most (i.e., 80%+) healthy newborns received DCC overall and by facility characteristics (i.e., Baby-Friendly designation, teaching status, type, annual live births, and annual Cesarean section rate). Results2,042 hospitals were included, and 50% reported that most healthy newborns received DCC. DCC prevalence was 49% at non-Baby Friendly hospitals and 53% at Baby-Friendly hospitals. The prevalence of healthy newborns receiving DCC was 50% at teaching hospitals and 51% at non-teaching hospitals. DCC prevalence ranged from 43% among private hospitals to 52% among non-profit hospitals, from 46% among hospitals with 2,000–4,999 births births/year to 53% among hospitals with <500 births/year, and from 37% among hospitals with annual Cesarean section rates ≥35% to 61% among hospitals with annual Cesarean section rates <25%. ConclusionsThis study provides a national baseline for DCC among US hospitals. Only half of hospitals report DCC for most healthy newborns with notable variation by annual Cesarean section rate. There are opportunities to increase DCC prevalence to meet recommendations through continued training of clinicians, modification of obstetric protocols, and greater awareness among patients. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Funding SourcesNo funding was provided for this study.