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Delaying umbilical cord clamping significantly reduces the risk of death in premature babies

20 Nov 2023
  • INFANT researchers are part of international collaboration highlighting benefits of deferred cord clamping in preterm infants.
  • Waiting for two minutes to clamp the umbilical cord of a premature baby soon after birth could significantly reduce the risk of death relative to immediate clamping.
  • Worldwide almost 13 million babies are born prematurely each year and close to 1 million die shortly after birth.

Waiting for at least two minutes to clamp the umbilical cord of premature babies at birth could decrease the child's risk of death, two new studies find.

Researchers at the Irish Centre for Maternal and Child Health Research (INFANT) at University College Cork were part of the major international iCOMP collaboration which examined clinical trial data and outcomes of thousands of premature babies across the world.

Two trials conducted at Cork University Maternity Hospital contributed to this database, one of the world’s largest databases in this research field, with over 60 studies and including more than 9,000 babies.

Their findings are published in The Lancet.

The first paper, using data from 3,292 infants across 21 studies, found delayed clamping of the umbilical cord, clamped 30 seconds or more after birth, reduced the risk of death in premature babies compared to those whose umbilical cord was clamped immediately after birth. After analysis, this deferred clamping of the umbilical cord likely reduced the risk of death in premature babies by a third compared to immediate clamping.

The second paper analysed data from 47 clinical trials, which involved 6,094 babies, and compared different durations of delay, compared to immediate clamping or milking the umbilical cord. The authors found that the longer the delay in clamping, the greater the likely benefit. Waiting at least two minutes before clamping the cord of a premature baby may reduce the risk of death by two thirds compared to immediately clamping the cord.

Waiting two or more minutes to clamp the cord had a 91 percent probability of being the best treatment to prevent death shortly after birth. In comparison, immediate clamping had a very low probability (less than 1%) of being the best treatment for preventing death in premature babies.

Professor Eugene Dempsey, Horgan Chair in Neonatology, INFANT Centre UCC, who led the Irish trials said: “Until recently, the standard practice was to clamp the umbilical cord immediately after birth for premature babies. The findings from these reviews highlight the significant benefits of deferred cord clamping for preterm delivery, and it is clear now that except in rare circumstances, immediate clamping should be avoided.”

Professor Geraldine Boylan, Director of INFANT Centre, commented on the findings: “The high-impact findings published in The Lancet emphasise the importance of global collaborative research and clearly demonstrates the impact of clinical trials on neonatal care and outcomes for premature babies.”


University College Cork

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