Abstract
A brief delay in clamping the umbilical cord results in a placental transfusion that supplies the infant with a major source of iron during the first few months of life. Cord circulation continues for several minutes after birth and placental transfusion results in approximately 30% more blood volume. Gravity influences the amount of placental transfusion that an infant receives. Placing the infant skin-to-skin requires a longer delay of cord clamping (DCC) than current recommendations. Uterotonics are not contraindicated with DCC. Cord milking is a safe alternative to DCC when one must cut the cord prematurely. Recent randomized controlled trials demonstrate benefits for term and preterm infants from DCC. The belief that DCC causes hyperbilirubinemia or symptomatic polycythemia is unsupported by the available research. Delay of cord clamping substantively increases iron stores in early infancy. Inadequate iron stores in infancy may have an irreversible impact on the developing brain despite oral iron supplementation. Iron deficiency in infancy can lead to neurologic issues in older children including poor school performance, decreased cognitive abilities, and behavioral problems. The management of the umbilical cord in complex situations is inconsistent between birth settings. A change in practice requires collaboration between all types of providers who attend births.
Highlights
A brief delay in clamping the umbilical cord results in a placental transfusion that supplies the infant with a major source of iron during the first few months of life
The group may introduce the new policy with careful recording of what happens in a limited number of cases. This can be reviewed for discussion of problems that arise with appropriate adjustments before the policy is recommended for all providers
SUMMARY This article offers high quality evidence that shows that receiving a placental transfusion at birth protects the infant from low iron stores and anemia during the first 6 months of life—a time of maximum brain growth
Summary
Great amount pregnancy, PRBV significantly of PRBV blood unmedicated VD; higher in EC group was drained from excludes SGA, LGA,. 139 status contributed to to control for many (Mexico) the 2006 study DCC: at 2 min 45 Infants with EC had more Hb alone may not be an et al[14] singletons, normal DCC: after anemia at 4 mo. Follow-up up DCC offers a strategy to after birth if nuchal Level: below to 6 mo showed no reduce early infant cord, anomalies or introitus at 10 difference in Hb or ZPP. P = .0003) than EC differences in Hb or Hct smokers; no IUGR infants.
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