| published 19-06-2007
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A recent meta-analysis of delayed cord clamping at delivery, reported in JAMA, found evidence of improved hematological status (higher hematocrit, ferritin, less frequent anemia) in infants following delayed cord clamping than with normal (non-delayed) clamping.
As the accompanying editorial points out, the level of certainty of this information (being from a meta-analysis) is such that doctors may want to consider the practice, but more research including large randomized-controlled trials are needed before making it a recommendation.
I'm particularly concerned, in our environment, with the possible side effects. Although the meta-analysis reported "no significant" increase in negative outcomes, there were "non-significant" increases in the frequency of transient respiratory distress and in bilirubin levels. The relative risk factor for respiratory distress was about 2.5, which would definitely be clinically relevant. The fact that this was found not to be statistically significant indicates, if I understand correctly, that the data was not adequate to address the question (i.e., the studies and meta-analysis were underpowered for these issues).
So, if you try delayed cord clamping, just keep a close watch on the babies for jaundice and tachypnea.
Late vs early clamping of the umbilical cord in full-term neonates: systematic review and meta-analysis of controlled trials. JAMA. 2007 Mar 21;297(11):1241-52.
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