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Research backs call to delay cord clamping

Later cord clamping would reduce iron-deficiency anaemia with few risks

Louise Prime

Wednesday, 16 November 2011

Research has provided strong evidence that delaying cord-clamping would protect babies from iron deficiency with little risk of other problems such as jaundice – a year after OnMedica reported an obstetrician’s call for NICE to follow WHO advice on the matter.

The randomised controlled trial, reported today on bmj.com, showed that delaying cord clamping for at least three minutes after birth protects healthy newborns from iron-deficiency anaemia, and experts say the practice should now become standard care after an uncomplicated pregnancy.

Researchers in Sweden randomised 400 babies, born after a low-risk pregnancy, to cord clamping either within 10 seconds of delivery or at least 3 minutes after birth, and followed them to assess the effect on their subsequent iron status.

They found that babies whose cords had been clamped later were less likely to suffer neonatal anaemia, and had better iron levels at 4 months old, than babies whose cords had been clamped immediately. Babies who had delayed cord clamping had no additional risk of adverse health effects, such as postnatal respiratory symptoms, polycythaemia, or hyperbilirubinaemia requiring phototherapy.

The authors said their results showed that delayed cord clamping “should be considered as standard care for full term deliveries after uncomplicated pregnancies”.

The author of a linked editorial agreed that the evidence is now strong enough to encourage delayed clamping. He said: “The balance of maternal risks and infant benefits of delayed cord clamping now clearly favours the child. How much more evidence is needed to convince obstetricians and midwives that it is worthwhile to wait for three minutes to allow for placental transfusion, even in developed countries?”

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