Delayed cord clamping in preterm infants delivered at 34 to 36 weeks gestation: A randomized controlled trial

Kees Ultee ^1*, Joost Swart ², Hans van der Deure ³, Carole Lasham ⁴ and Anneloes van Baar ⁵

¹ Deventer Ziekenhuis, Netherlands
² Wilhelmina kinder ziekenhuis Utrecht, Netherlands
³ Deventer hospital, Netherlands
⁴ Ziekenhuis Gooi-Noord, Netherlands
⁵ Tilburg university, Netherlands

^* To whom correspondence should be addressed. E-mail: ulteec{at}dz.nl.

Accepted 6 February 2007

Abstract

Background: Even mild iron deficiency and anaemia in infancy may be associated with cognitive deficits. A delay in clamping of the cord improves haematocrit levels and result in greater vascular stability and lesser need for packed cell transfusions for anaemia in the first period after birth. Follow-up data on haemoglobin levels after the neonatal period was not available.

Aim: To provide neonatal and follow up data concerning the effects of early or delayed clamping of the cord.

Methods: 37 premature infants (gestational age 34+0/7 - 36+6/7 weeks) were randomly assigned to one of two groups in the first hour after birth, as well as at 10 weeks of age. In one group the umbilical cord was clamped within 30 seconds (mean 13.4, SD 5.6) and in the other it was clamped at 3 minutes after delivery. In the neonatal period blood glucose and haemoglobin levels were determined. At 10 weeks of age haemoglobin and ferritin was analysed.

Results: The late cord clamped group showed consistently higher haemoglobin levels, both at the age of one hour mean 13.4 mmol/l (SD 1.9) versus mean 11.1 mmol/l (SD 1.7) and at 10 weeks mean 6.7 mmol/l (SD .75) versus mean 6.0 mmol/l (SD .65). No relationship between delayed clamping of the umbilical cord and pathological jaundice or polycythaemia was found.

Conclusion: Immediate clamping of the umbilical cord should be discouraged

Keywords: early umbilical cord clamping, late umbilical cord clamping, neonatal anaemia, neonatal polycythaemia, prematurity

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