Perspectives on implementing delayed cord clamping

Area of Science:

• Neonatal care
• Obstetrics
• Perinatal medicine

Background:

• Delayed cord clamping (DCC) is increasingly supported by evidence for both term and preterm infants.
• Early cord clamping (ECC) remains common practice, potentially due to persistent concerns and lack of awareness.
• Professional organizations widely recommend DCC for preterm infants, but its adoption for term infants varies, especially in well-resourced settings.

Purpose of the Study:

• To explore the reasons behind the continued use of early cord clamping (ECC).
• To address and debunk common concerns regarding polycythemia and jaundice associated with DCC.
• To highlight emerging evidence on the benefits of DCC, including improved resuscitation in compromised infants.

Main Methods:

• Review of existing literature, including randomized controlled trials on cord clamping practices.
• Analysis of professional organization recommendations and guidelines.
• Discussion of multiple perspectives on the implementation of DCC.

Main Results:

• Years of research, including randomized controlled trials, do not substantiate concerns about polycythemia and jaundice with DCC.
• New data suggest potential benefits of DCC for resuscitative efforts in compromised infants.
• Despite recommendations, ECC persists, particularly for term infants in some settings.

Conclusions:

• The evidence supporting DCC for both term and preterm infants is expanding.
• Persistent concerns about adverse effects of DCC are not supported by robust scientific data.
• Consideration of DCC as standard practice is encouraged, with attention to implementation challenges and benefits.