Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes

McDonald, Susan; Middleton, Philippa; Dowswell, Therese; Morris, Peter S.

doi:10.1002/14651858.cd004074.pub3

Cited by 383 publications

(237 citation statements)

References 73 publications

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“…However, there is considerable variation between babies. A Cochrane review [15] of 15 trials including 3,911 women and term infant pairs showed no negative maternal effects of delayed cord clamping. Delayed cord clamping increased the newborn's hemoglobin at 12-24 h of age, as well as the risk of jaundice needing phototherapy, and reduced iron deficiency at 3-6 months of age.…”

Section: Cord Clamping and Cord Milkingmentioning

confidence: 99%

“…Delayed cord clamping increased the newborn's hemoglobin at 12-24 h of age, as well as the risk of jaundice needing phototherapy, and reduced iron deficiency at 3-6 months of age. However, delayed cord clamping was defined differently in these studies - from 30 s to 1 or even 5 min after birth or until the cord stopped pulsating [15]. …”

Section: Cord Clamping and Cord Milkingmentioning

confidence: 99%

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Delivery Room Management of Term and Preterm Newly Born Infants

Saugstad¹

2015

Neonatology

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Delivery room management, especially in the first ‘golden' minute, is of the utmost importance. An exact and universal definition of when a baby is born is needed to obtain agreement on what is meant by the first minute of life. Education of young girls is a basic requirement to optimize the health of the mother and baby. Interventions in pregnancy should as far as possible be evidence based. Antenatal care, the selection of birth mode and antenatal steroid therapy when indicated also contribute to obtaining the best outcome. Delayed cord clamping is recommended for both preterm and term infants. However, more data are needed regarding the most immature infants. Routine suctioning of the mouth and airways is not required. Thermal control is important - keep the temperature in the delivery room at 26°C and wrap infants <28 weeks of gestation in plastic. However, this procedure does not reduce mortality. Since delayed cord clamping increases mean birth weight by approximately 30 g/kg, the present birth weight charts based on early clamping need to be corrected. Preterm infants in need of ventilatory support should start with CPAP from the first breath. A T-piece device seems to have some advantages compared to self-inflating bags. Surfactant instillation is often not needed prophylactically provided the mother has received antenatal steroids. Less invasive methods for administering surfactant may be useful. If ventilatory support is needed, start with air in term and near-term infants. For babies of 29-33 weeks of gestation start with 21-30% oxygen and for infants <29 weeks start with 30% oxygen and adjust according to the response obtained.

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Section: Cord Clamping and Cord Milkingmentioning

confidence: 99%

Section: Cord Clamping and Cord Milkingmentioning

confidence: 99%

Delivery Room Management of Term and Preterm Newly Born Infants

Saugstad¹

2015

Neonatology

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“…The timing of cord clamping (CC) as an active intervention during the third stage of labour is recognized as an important factor in influencing perinatal and maternal outcomes [1,2,3]. Several studies have investigated the timing of CC and its direct effects, describing the risks and benefits for both early and delayed CC (ECC and DCC) [1,2,3,4,5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have investigated the timing of CC and its direct effects, describing the risks and benefits for both early and delayed CC (ECC and DCC) [1,2,3,4,5,6]. DCC has been shown to decrease the risk of anaemia, hypovolemia and respiratory distress syndrome [1,3,5,6], while the risk for hyperbilirubinemia is increased [1,2,3,7]. …”

Section: Introductionmentioning

confidence: 99%

Current Practice of Cord Clamping in The Netherlands: A Questionnaire Study

Boere¹,

Smit²,

Roest³

et al. 2014

Neonatology

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Background: Recent meta-analyses recommend delayed cord clamping (DCC) after uncomplicated births as well as preterm births, but there is no clear definition of timing and uniform national guidelines are lacking. Objective: We aimed to investigate if guidelines for the timing of cord clamping (CC) are followed and what the national practice entails. Methods: A postal questionnaire concerning CC after uncomplicated vaginal, Caesarean term and preterm deliveries was sent to all midwifery practices (n = 526) and obstetrical departments (n = 94) in the Netherlands. Results: The response rate was 81% (500/620). CC protocols were present in 16 and 38% of midwifery and obstetric practices, respectively. Early cord clamping (ECC) was recommended in 54%, DCC in 33%, 6% indicated a specific time point and 7% did not specify. In current practice, DCC was applied after uncomplicated vaginal term deliveries in 90% and ECC in 6%, and no timing was specified in 4%. Midwives used DCC more often than obstetricians (97 vs. 75%). Cessation of cord pulsations was often (54%) used as a time point, 40% used a fixed time point, 2% waited for placental expulsion and 4% did not specify. ECC was preferred in obstetric practices after Caesarean deliveries (in 81%). In preterm births, ECC was practised by 36%, DCC by 54 and 10% did not specify. Conclusion: In the Netherlands, although often not protocolized, DCC is widely used after uncomplicated vaginal term and preterm deliveries, but not after Caesareans. Cessation of cord pulsation is often used as the time point for CC.

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“…Para reducir la anemia en lactantes, se debería iniciar la suplementación con hierro, entre los dos a cuatro meses de edad, especialmente en los nacidos de madres anémicas, así como fomentar el clampaje tardío del cordón umbilical para mejorar los depósitos de hierro (21)(22) . Se debe realizar un seguimiento a los recién nacidos de madres anémicas, e incluir la evaluación de hemoglobina antes de los 6 meses de edad.…”

Section: Discussionunclassified

Anemia y estado nutricional en lactantes de dos a cinco meses atendidos en establecimientos del Ministerio de Salud del Perú, 2012

Gómez-Guizado

Munares-García

2014

Rev Peru Med Exp Salud Publica

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RESUMENObjetivos. Determinar las características de los niveles de anemia en lactantes de dos a cinco meses de edad atendidos en los establecimientos del Ministerio de Salud del Perú durante el año 2012. Materiales y métodos. Estudio transversal utilizando la base de datos del Sistema de Información del Estado Nutricional del Centro Nacional de Alimentación y Nutrición del Instituto Nacional de Salud del Perú del año 2012. Se analizaron los registros de 7513 lactantes de dos a cinco meses de edad atendidos en puestos, centros y hospitales del Ministerio de Salud de las 25 regiones del Perú. Se utilizaron estadísticas descriptivas y de regresión logística. Resultados. El 10,2% (IC 95%: 9,5-10,9) de los lactantes presentaron anemia, con diferencias en las frecuencias según los meses de edad (p<0,001), altitud a nivel del mar (p<0,001), regiones (p<0,001) y tipo de establecimiento (p<0,001). En el análisis multivariable se encontraron como factores asociados con tener anemia la edad de 4 meses (OR 1,2; IC 95%: 1,0-1,5) y 5 meses (OR 1,4; IC 95%: 1,2-1,6), presentar obesidad (OR 0,7; IC 95%: 0,5-1,0) y desnutrición crónica (OR 1,3; IC 95%: 1,0-1,6). Conclusiones. Se evidencio la presencia de anemia y desnutrición crónica antes de los 6 meses de edad y que la probabilidad de tener anemia se incrementa conforme aumenta la edad y está asociada a algunos componentes del estado nutricional. Palabras clave: Anemia; Estado nutricional; Lactante; Desnutrición (fuente: DECS/BIREME). ANEMIA AND NUTRITIONAL STATUS OF INFANTS FROM TWO TO FIVE MONTHS OF AGE TREATED IN FACILITIES OF THE MINISTRY OF HEALTH OF PERU, 2012 ABSTRACTObjectives. Determine the characteristics of the levels of anemia in infants from two to five months of age treated in facilities of the Ministry of Health of Peru during 2012. Materials and methods. This cross-sectional study uses the nutritional status information system of the National Center for Food and Nutrition, National Institute of Health of Peru in 2012. Records of 7,513 infants from two to five months of age treated in small outpatient clinics, centers and hospitals of the Ministry of Health of Peru's 25 regions were analyzed. Descriptive statistics and logistic regression techniques were used for data analysis. Results. 10.2% (95% CI 9.5-10.9) of the infants had anemia, with frequency differences by month of age (p<0.001), altitude, (p<0.001) regions (p<0.001) and type of facility (p<0.001). In the multivariate analysis, factors associated with anemia were: age of 4 months (OR 1.2; 95% CI 1.0-1.5), age of 5 months (OR 1.4; 95% CI 1.2-1.6), obesity (OR 0.7; 95% CI 0.5-1.0) and chronic malnutrition (OR 1.3; 95% CI 1.0-1.6). Conclusions. The presence of anemia and chronic malnutrition before 6 months of age was evidenced, as well as that the probability of anemia increases with age and is associated with some components of nutritional status.

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Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes

Cited by 383 publications

References 73 publications

Delivery Room Management of Term and Preterm Newly Born Infants

Delivery Room Management of Term and Preterm Newly Born Infants

Current Practice of Cord Clamping in The Netherlands: A Questionnaire Study

Anemia y estado nutricional en lactantes de dos a cinco meses atendidos en establecimientos del Ministerio de Salud del Perú, 2012

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