Latest paper on delayed cord clamping shows no benefit for premature babies

I’ve written before that delayed cord clamping has been found to have no clinical benefits in term infants, but there has been some evidence that it is beneficial for premature babies because it reduces the need for blood transfusions in babies who are likely to develop anemial of prematurity. The latest paper on the topic puts even that claim in doubt.

Delayed Umbilical Cord Clamping in Premature Neonates will appear in the August issue of Obstetrics and Gynecology. The authors explain:

This was a before–after investigation com- paring early umbilical cord clamping with delayed um- bilical cord clamping (45 seconds) in two groups of singleton neonates, very low birth weight (VLBW) (401– 1,500 g) and low birth weight (LBW) (greater than 1,500 g but less than 35 weeks gestation). Neonates were excluded from delayed umbilical cord clamping if they needed immediate major resuscitation. Primary out- comes were provision of delivery room resuscitation, hematocrit, red cell transfusions, and the principle Vermont Oxford Network outcomes.

What did they find?

All neonates had a hematocrit determination (largely peripheral venous) 30 – 60 minutes after birth… VLBW and LBW neonates who underwent delayed umbilical cord clamping had a significantly higher hematocrit, but delayed umbilical cord clamping did not significantly lower the overall NICU red blood cell transfusion rate. Delayed cord clamping was associated with higher mean systolic and diastolic blood pressures in neonates with LBW. Highest measured total bilirubin concentration and use of phototherapy were not significantly different between the early umbilical cord clamping and delayed umbilical cord clamping groups… [W]e observed no significant differences in any of the principle Vermont Oxford Network VLBW morbidities, mor- tality, growth rates, or length of stay …

Delayed cord clamping made no difference in the incidence of chronic lung disease, retinopathy of prematurity, intraventricular hemorrhage, necrotizing enterocolitis, infection, weight gain or length of stay. Obviously, the intitial hematocrit was higher in infants who underwent delayed cord clamping, but it resulted in no appreciable benefits.

The authors do point to one benefit, but fail to realize that it is a direct result of study design, not delayed cord clamping.

… [T]he overall provision of any delivery room resuscitation intervention was signifi- cantly less in the VLBW delayed umbilical cord clamping group (61% compared with 79%, P=.01) but not different between the LBW groups (30% compared with 27%, P=.55). Delayed umbilical cord clamping was associated with higher Apgar scores at 1 minute in VLBW neonates but no significant differ- ences in neonates with LBW….

That was only to be expected because:

… eligible neonates born in the second era did not have delayed umbilical cord clamping because the health care providers felt the neonate needed immediate major resuscitation. These six neonates had a mean postmenstrual age of 31 0/7 weeks, mean birth weight 1,618 g, Apgar score at 1 minute ranged from 0 to 5, Apgar score at 5 minutes ranged from 2 to 7, and all survived…

In other words, infants with the greatest need for resusciation were autonomatically excluded from the deleyed cord clamping group, but not the early cord clamping group. It’s hardly surprising then, that the delayed cord clamping group had fewer infants in need of resuscitation.

The authors conclude:

Delayed umbilical cord clamping can safely be performed in singleton premature neonates and is associated with a higher hematocrit, less delivery room resuscitation, and no significant changes in neonatal morbidities.

Even that tepid endorsement overstates the case. Obviously the hematocrit was initially higher in the delayed cord clamping group; delayed cord clamping inevitably increases the hematocrit initially. Obviously there was less need for resuscitation in the delayed cord clamping group since the infants with the greatest need for resuscitation had been removed from the group.

The bottom line is that delayed cord clamping provided no benefit of any kind.

Trackbacks/Pingbacks

  1. canada pharmacy - July 27, 2021

    canada pharmacy

    […]check below, are some completely unrelated web-sites to ours, nonetheless, they may be most trustworthy sources that we use[…]

  2. where to buy glo extracts - July 26, 2021

    where to buy glo extracts

    […]check below, are some completely unrelated internet sites to ours, having said that, they’re most trustworthy sources that we use[…]

  3. buy kush online cheap - July 26, 2021

    buy kush online cheap

    […]Here is an excellent Blog You might Discover Interesting that we Encourage You[…]

  4. shop marijuana online - July 26, 2021

    shop marijuana online

    […]one of our guests not too long ago advised the following website[…]

  5. معرفة هوية المتصل - July 26, 2021

    معرفة هوية المتصل

    […]below you will come across the link to some websites that we think you’ll want to visit[…]

  6. Order Handgun Firearms Online - July 25, 2021

    Order Handgun Firearms Online

    […]please visit the web-sites we follow, including this 1, because it represents our picks through the web[…]

  7. buy Juul pods online - July 25, 2021

    buy Juul pods online

    […]the time to study or check out the subject material or web pages we’ve linked to beneath the[…]

  8. hbcuex.com - July 25, 2021

    hbcuex.com

  9. latest technology - July 25, 2021

    latest technology

  10. Find out more - July 24, 2021

    Find out more

    […]although internet sites we backlink to beneath are considerably not connected to ours, we really feel they may be truly really worth a go as a result of, so possess a look[…]

  11. permanent hair removal - July 24, 2021

    permanent hair removal

    […]The details talked about in the article are a number of the best readily available […]

  12. sex toys - July 23, 2021

    sex toys

    […]just beneath, are several totally not connected sites to ours, nonetheless, they’re certainly really worth going over[…]

  13. bunnings shed - July 21, 2021

    bunnings shed

    […]very few web sites that happen to be comprehensive beneath, from our point of view are undoubtedly nicely really worth checking out[…]

  14. how to lose belly fat fast - July 18, 2021

    how to lose belly fat fast

    […]the time to read or go to the subject material or sites we have linked to beneath the[…]

  15. buy dungeness crab online - July 16, 2021

    buy dungeness crab online

    […]very couple of internet sites that take place to become comprehensive below, from our point of view are undoubtedly properly worth checking out[…]

  16. cheap 100 round drum for ar 15 - July 16, 2021

    cheap 100 round drum for ar 15

    […]Here is a good Weblog You might Discover Intriguing that we Encourage You[…]

  17. Squat Rack - July 16, 2021

    Squat Rack

  18. Thc Oil Carts - July 14, 2021

    Thc Oil Carts

    https://theclearconcerntrate.com/ The Clear classic oil is mixed with CBD isolate and our preparatory flavorings for the best taste and consistency on the market today.

  19. Pallas Cat - July 14, 2021

    Pallas Cat

    […]Here are some of the web-sites we suggest for our visitors[…]

  20. Sig P365 Xl - July 14, 2021

    Sig P365 Xl

    […]one of our guests recently proposed the following website[…]

  21. captain beds near me - July 14, 2021

    captain beds near me

  22. canada pharmacy review - July 13, 2021

    canada pharmacy review

    […]we came across a cool web site which you may possibly delight in. Take a look in case you want[…]

  23. Roofers Parksville - July 13, 2021

    Roofers Parksville

    […]here are some links to sites that we link to for the reason that we feel they may be worth visiting[…]

  24. escort bayan istanbul - July 13, 2021

    escort bayan istanbul

    […]The facts talked about inside the post are a number of the most effective obtainable […]

  25. ท่า sex แนบชิด “Coital Alignment Technique (CAT) - July 10, 2021

    … [Trackback]

    […] Read More Info here on that Topic: skepticalob.com/2012/07/latest-paper-on-delayed-cord-clamping.html […]

  26. Google - July 9, 2021

    Google

    Here are some links to websites that we link to due to the fact we consider they are worth visiting.

  27. Google - July 8, 2021

    Google

    Usually posts some very exciting stuff like this. If you are new to this site.

  28. bilişim danışmanlık firmaları - July 3, 2021

    … [Trackback]

    […] There you can find 3791 more Information on that Topic: skepticalob.com/2012/07/latest-paper-on-delayed-cord-clamping.html […]

  29. lessons - February 16, 2013

    Title…

    […]we came across a cool website which you could possibly get pleasure from. Take a appear in the event you want[…]…

  30. florida home insurance quotes - February 15, 2013

    Title…

    […]here are some links to web sites that we link to mainly because we think they may be worth visiting[…]…

  31. yepi 2 - February 15, 2013

    Title…

    […]one of our visitors not too long ago recommended the following website[…]…

  32. Dr Oz Garcinia Cambogia Review - February 15, 2013

    Title…

    […]below you’ll discover the link to some web-sites that we consider you should visit[…]…

Leave a Reply

You must be logged in to post a comment.