Article Text

Download PDFPDF
Timing is everything
  1. Arjan B te Pas
  1. Correspondence to Dr Arjan B te Pas, Division of Neonatology, Department of Pediatrics, Leiden University Medical Centre, Leiden 2300 RC, The Netherlands; a.b.te_pas{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

A meta-analysis of 15 small studies comparing early (<30 s) versus late (30–180 s) cord clamping in preterm infants demonstrated a decrease in hypotension, intraventricular haemorrhage, necrotising enterocolitis and number of transfusions, as well as an increase in haematocrit and blood volume.1 The authors concluded that the meta-analysis was inconclusive due to several biases—preterm infants needing resuscitation were excluded from all the studies, for example—and considerable variation in methods.1 More research therefore needs to be done. Despite the lack of evidence, however, current neonatal resuscitation guidelines suggest delaying cord clamping for at least 30 s in preterm infants needing no resuscitation.2 So far preterm infants needing resuscitation were excluded from the studies and immediate cord clamping is still recommended in order not to delay support.

Duley et al 3 have addressed this question and performed a multicentre trial in preterm infants comparing immediate cord clamping within 20 s with clamping after 2 min, providing resuscitation if needed. The results are published in this issue. Considerable hurdles had to be overcome before the caregivers in all eight participating centres felt comfortable waiting for over a minute before cord clamping; the researchers should be commended for …

View Full Text


  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

Linked Articles

  • Original article
    Lelia Duley Jon Dorling Angela Pushpa-Rajah Sam J Oddie Charles William Yoxall Bernard Schoonakker Lucy Bradshaw Eleanor J Mitchell Joe Anthony Fawke on behalf of the Cord Pilot Trial Collaborative Group Lindsay Armstrong-buisseret Brian Barnes Natalie Hutchings Keith Whittaker Kate Branchett Mike Clarke Richard Cooke Liz Goddard Sara Kenyon Philip Steer Douglas Altman Declan Devane Andrew Shennan Ben Stenson Jane Abbott Zoe Chivers Gill Gyte Robert Dineen David Field Jim Thornton William Tarnow-mordi Medhat Ezzat Nikolaus Kau Vijender Kistareddy Annie Robertson Amal Mighell Kelly Young Dushyant Batra Carys Smith Kumar Swamy Narendra Aladangady Amit Kandhari Elaine Van Der Ros Astles Marie Hubbard Penny Mcparland Margaret Thomas Andrew Weeks Kate Cheshire David Churchill Tilly Pilley Melanie Sutcliffe George Bugg Yvonne Hooton Gill Kirkwood