Delayed umbilical cord clamping appears to be beneficial for term and preterm infants. In term infants,
delayed umbilical cord clamping increases
hemoglobin levels at birth and improves
iron stores in the first several months of life, which may have a favorable effect on developmental outcomes. There is a small increase in the incidence of
jaundice that requires
phototherapy in term infants undergoing
delayed umbilical cord clamping. Consequently, obstetrician-gynecologists and other obstetric care providers adopting
delayed umbilical cord clamping in term infants should ensure that mechanisms are in place to monitor and treat
neonatal jaundice. In preterm infants,
delayed umbilical cord clamping is associated with significant neonatal benefits, including improved transitional circulation, better establishment of red blood cell volume, decreased need for
blood transfusion, and lower incidence of
necrotizing enterocolitis and intraventricular
hemorrhage.
Delayed umbilical cord clamping was not associated with an increased risk of
postpartum hemorrhage or increased blood loss at delivery, nor was it associated with a difference in postpartum
hemoglobin levels or the need for
blood transfusion. Given the benefits to most newborns and concordant with other professional organizations, the American College of Obstetricians and Gynecologists now recommends a delay in
umbilical cord clamping in vigorous term and preterm infants for at least 30-60 seconds after birth. The ability to provide
delayed umbilical cord clamping may vary among institutions and settings; decisions in those circumstances are best made by the team caring for the mother-infant dyad.