Should delayed cord clamping be the standard of care in term low risk deliveries? A randomized controlled trial from a medical college hospital in south India

Krishnan, Lalitha; Kommu, Peter Prasanth Kumar; Thomas, Basil John; Akila, Bridgitte; Daniel, Mary

doi:10.4103/2249-4847.159904

Cited by 7 publications

(2 citation statements)

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“…A. Subgroups according to gestational age: For the important outcome of hyperbilirubinemia treated with phototherapy among term infants (≥37 weeks’ gestation), low-certainty evidence from 13 trials involving 2691 infants 245,249,252,257,259,262,264,265,268–270,288,289 showed that more term infants in the later cord clamping group received phototherapy for hyperbilirubinemia (RR, 1.54 [95% CI, 1.01–2.34]; risk difference, 0.01 [95% CI, 0.00–0.03]; number needed to harm, 100; I 2 =15%); 10 of 1000 more (95% CI, 0–30 more per 1000) term infants had hyperbilirubinemia treated with phototherapy after later cord clamping compared with early cord clamping. Among late preterm infants (34 to 36 +6 weeks’ gestation), low-certainty evidence from 2 trials involving 123 infants 256,267 could not exclude benefit or harm from later cord clamping compared with early cord clamping (RR, 0.72 [95% CI, 0.37–1.40]; I 2 =0%).…”

Section: Neonatal Life Supportmentioning

confidence: 99%

2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group

Wyckoff¹,

Singletary²,

Soar³

et al. 2022

Circulation

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The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.

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Section: Neonatal Life Supportmentioning

confidence: 99%

2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group

Wyckoff¹,

Singletary²,

Soar³

et al. 2022

Circulation

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“…Data from 15 studies [ 55 , 58 , 61 , 62 , 67 , 69 – 71 , 77 , 89 , 93 – 95 , 99 , 100 ] and 2 082 infants suggest that DCC results in little to no difference in length of hospital stay (MD=-0.19 days, CI:-0.59 to 0.20, p =0.34, I2=53%, low certainty evidence) (Fig. 15 ).…”

Section: Resultsmentioning

confidence: 99%

Umbilical cord milking and delayed cord clamping for the prevention of neonatal hypoglycaemia: a systematic review and meta-analysis

Watson,

Roberts,

Harding

et al. 2024

BMC Pregnancy Childbirth

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Background Placental management strategies such as umbilical cord milking and delayed cord clamping may provide a range of benefits for the newborn. The aim of this review was to assess the effectiveness of umbilical cord milking and delayed cord clamping for the prevention of neonatal hypoglycaemia. Methods Three databases and five clinical trial registries were systematically reviewed to identify randomised controlled trials comparing umbilical cord milking or delayed cord clamping with control in term and preterm infants. The primary outcome was neonatal hypoglycaemia (study defined). Two independent reviewers conducted screening, data extraction and quality assessment. Quality of the included studies was assessed using the Cochrane Risk of Bias tool (RoB-2). Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Meta-analysis using a random effect model was done using Review Manager 5.4. The review was registered prospectively on PROSPERO (CRD42022356553). Results Data from 71 studies and 14 268 infants were included in this review; 22 (2 537 infants) compared umbilical cord milking with control, and 50 studies (11 731 infants) compared delayed with early cord clamping. For umbilical cord milking there were no data on neonatal hypoglycaemia, and no differences between groups for any of the secondary outcomes. We found no evidence that delayed cord clamping reduced the incidence of hypoglycaemia (6 studies, 444 infants, RR = 0.87, CI: 0.58 to 1.30, p = 0.49, I2 = 0%). Delayed cord clamping was associated with a 27% reduction in neonatal mortality (15 studies, 3 041 infants, RR = 0.73, CI: 0.55 to 0.98, p = 0.03, I2 = 0%). We found no evidence for the effect of delayed cord clamping for any of the other outcomes. The certainty of evidence was low for all outcomes. Conclusion We found no data for the effectiveness of umbilical cord milking on neonatal hypoglycaemia, and no evidence that delayed cord clamping reduced the incidence of hypoglycaemia, but the certainty of the evidence was low.

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Effects of delayed cord clamping on infants after neonatal period: A systematic review and meta-analysis

Zhao

Hou

Zhu

et al. 2019

International Journal of Nursing Studies

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Should delayed cord clamping be the standard of care in term low risk deliveries? A randomized controlled trial from a medical college hospital in south India

Cited by 7 publications

References 0 publications

Umbilical cord milking and delayed cord clamping for the prevention of neonatal hypoglycaemia: a systematic review and meta-analysis

Effects of delayed cord clamping on infants after neonatal period: A systematic review and meta-analysis

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