Revert to the original: time to re-establish delayed umbilical cord clamping as the standard approach for preterm

Ryan M McAdams1, Carl H Backes2, Omid Fathi2

  • 11Department of Pediatrics, Division of Neonatology, University of Wisconsin School of Medicine and Public Health, 1010 Mound St., Rm 414, Madison, WI 53715 USA.

Delayed cord clamping, the common term used to denote placental-to-newborn transfusion at birth, is a practice now endorsed by the major governing bodies affiliated with maternal-newborn care. Despite considerable evidence, delayed cord clamping, not early cord clamping, continues to be viewed as the "experimental" intervention category when discussed in research studies. We provide a brief overview of placental-to-newborn transfusion in relation to birth transitional physiology and discuss areas where we may need to modify our interpretation of "normal" vital signs and laboratory values as delayed cord clamping becomes standardized. We also assert that delayed cord clamping should now be viewed as the standard of care approach, especially given that multiple randomized controlled trials have revealed that early cord clamping, which lacks evidence-based support, is associated with a greater risk for morbidity and mortality than delayed cord clamping.

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