Summary
-
A comprehensive review of six randomized clinical trials and 610 infants demonstrated no difference in mortality before discharge between immediate cord cutting (ICC) and delayed cord cutting (DCC) prior to resuscitation.
-
There were small differences, that did not reach statistical significance in oxygen saturation, temperature at NICU admission between the DCC and ICC groups.
- There were no other early complications, including intraventricular hemorrhage, necrotizing enterocolitis, retinopathy of prematurity or bronchopulmonary dysplasia.
- Blood transfusion, surfactant therapy, phototherapy need, hypothermia at NICU admission, and maternal blood loss did not differ between groups DCC and ICC.
- The research found there was no major impact on immediate newborn health after delaying cord clamping before resuscitation however the effects of long term consequences warrant additional study.
In a recent medical research, the beneficial effects of delayed cord clamping (DCC) on preterm and term infants were compared with immediate cord cutting (ICC) provided before starting resuscitation after birth. This evaluation was performed in a comparehensive analysis of data from 610 infants across six randomized controlled trials (RCTs), and looked at multiple outcomes including: i) mortality; ii) delivery room parameters; iii) early complications of prematurity: iv. safety parameters.
The analysis showed no substantial difference between those infants receiving ICC and DCC before resuscitation in relation to in-hospital mortality. The study found no impact on neonatal death from timing of cord clamping. Oxygen saturation levels, Apgar scores, and temperature at NICU admission were also assessed in the birth room. There were slight, but non-significant differences in oxygen saturations between the two groups.
Early complications included intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), retinopathy of the prematurity (ROP), bronchopulmonary dysplasia, patent ductus arteriosus and late-onset sepsis. The study also found no clinically or statistically significant differences in the occurrence of these issues between infants who underwent ICC and those who had DCC.
The study assessed blood transfusion, surfactant therapy in NICU and safety parameters such as phototherapy need, hypothermia at admission to the neonatal intensive care unit (NICU), maternal blood loss, postpartum haemorrhage and infection. The analysis showed that there were no differences in these outcomes between the two groups, meaning delayed cord clamping does not improve any of these health-related aspects.
The study thus concluded that delaying the clamping of the umbilical cord prior to initiation of resuscitation in asphyxiated infants at birth does not lead to significant differences on either: mortality during hospital stay, characterises at delivery room or early morbidities for premature neonates and safety endpoints. These results indicate that the time at which cord clamping is performed may not be a significant determinant of immediate newborn health. Still, we need more data to really know what might be the long-term effects of delayed cord clamping on infant health and development.
Ob/Gyn & Women’s Health, Pediatrics, Nursing, Emergency Medicine