Original Paper

A Systematic Review and Meta-Analysis of a Brief Delay in Clamping the Umbilical Cord of Preterm Infants
Heike Rabe^a, Graham Reynolds^b, Jose Diaz-Rossello<sup>c

a</sup>Department of Neonatology, Brighton and Sussex University Hospitals, Brighton, UK;
^bDepartment of Women's and Child Health, Canberra Hospital, Canberra, Australia;
^cLatin American Centre for Perinatology, Pan American Health Organisation/World Health Organisation, Montevideo, Uruguay

Address of Corresponding Author

Neonatology 2008;93:138-144 (DOI: 10.1159/000108764)

  Key Words

• Preterm
• Infant
• Cord clamping
• Resuscitation

  Abstract

Background: The optimal timing of clamping the umbilical cord in preterm infants at birth is the subject of continuing debate. Objective: To investigate the effects of a brief delay in cord clamping on the outcome of babies born prematurely. Methods: A retrospective meta-analysis of randomised trials in preterm infants was conducted. Data were collected from published studies identified by a structured literature search in EMBASE, PubMed, CINAHL and the Cochrane Library. All infants born below 37 weeks gestation and enrolled into a randomised study of delayed cord clamping (30 s or more) versus immediate cord clamping (less than 20 s) after birth were included. Systematic search and analysis of the data were done according to the methodology of the Cochrane collaboration. Results: Ten studies describing a total of 454 preterm infants were identified which met the inclusion and assessment criteria. Major benefits of the intervention were higher circulating blood volume during the first 24 h of life, less need for blood transfusions (p = 0.004) and less incidence of intraventricular hemorrhage (p = 0.002). Conclusions: The procedure of a delayed cord clamping time of at least 30 s is safe to use and does not compromise the preterm infant in the initial post-partum adaptation phase.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Dr. Heike Rabe
Department of Neonatology, Brighton and Sussex University Hospitals
Eastern Road, Brighton BN2 5BE (UK)
Tel. +44 1273 696 955 (ext. 4195), Fax +44 1273 664 795
E-Mail Heike.Rabe@bsuh.nhs.uk

  Article Information

Received: December 28, 2006
Accepted after revision: July 17, 2007
Published online: September 21, 2007
Number of Print Pages : 7
Number of Figures : 0, Number of Tables : 2, Number of References : 25