Monday, March 20, 2023

Waiting to Clamp Umbilical Cord Best for Preemies

There are a lot of babies born each day that are premature, and a new study says that delaying the clamping of the umbilical cord by just 30 to 60 seconds can save that newborn’s life. This new research is coming out of Baylor University Medical Center’s neonatal intensive care unit, and the study was published in the American Journal of Obstetrics and Gynecology.


The study has found that just waiting 45 seconds before clamping down on the umbilical cord can reduce the potential for bleeding in the brain in the premature babies. The cord blood is packed with stem cells and immunoglobulins, and if these two things are pumped into the baby right after birth, it can help the child’s body repair itself naturally. Many years ago, children were left attached to the umbilical cord for minutes after birth, because even back then our ancestors understood the importance of the nutrient-rich umbilical cord. Chimpanzees leave the umbilical cord attached for days after delivery, and other animals keep the attachment even longer, so why are humans wanting to cut the cord immediately after birth? This new research study shows that there is animal instinct going on, and this is conflicting with modern medicine.

The investigators looked at 148 very premature infants, which were less than 32 weeks in gestation, and some were current cases with others being historic cases at Baylor. When the researchers compared the infants who were removed from the placenta and had their umbilical cord cut immediately and those who had a 45-second delay, there were evident effects that showed how beneficial waiting was. The principal lead investigator for the study was Arpitha Chiruvolu, and Chiruvolu said that there was about a 50 percent reduction in the intraventricular hemorrhage, which is another term for bleeding in the brain. There were no adverse effects of waiting, and there were significantly fewer babies who needed intubation in the delivery room. Not only was there reducing bleeding in the brain, which is one of the leading causes of death of premature infants, there also was a reduced need for early red blood cell transfusions. Red blood cell transfusions are done to negate blood loss, iron deficiency, and anemia. In the non-control babies, physicians had followed strict protocol when it came to delaying the clamping.

The process of delaying the cord clamping has become more popular in the full-term infants, but there was not any known application of this being done in the premature babies, since doctors were not sure if leaving the premature babies in the placenta could harm the baby even more. The American College of Obstetricians and Gynecologists endorsed the 30 to 60 second delay in all babies in 2012, so it was still unclear why doctors were hesitant to do this with the premature babies after that endorsement. The thought was that since premature babies are a vulnerable population, there was concern over delaying resuscitation if that needed to happen, which is why waiting another 30 to 60 seconds seemed scary and like an unneeded risk. A lot of the previous studies involved a small sample group of participants, which also could have contributed to the lack of delaying clamping in newborns, but this study since it was such a large size should give more credibility to the practice of delaying clamping.

Dr. Chiruvolu said that this study shows that by using strict protocol measures, delayed clamping can be used in a more mainstream manner, and can lead to very good outcomes for the premature infant population without having adverse effects. Of course, delaying clamping is not always a good thing to do, and delays longer than 60 seconds have been linked to neonatal jaundice, which then requires onsite phototherapy to fix. There are also cases where an infant is born with a breathing problem, and these babies need immediate cord cutting and resuscitation, so this would be an example of a case where delaying the cutting could be costly. Other than the special circumstances, there should be no reason why delayed clamping can’t become mainstream, and in the preemies it can actually save their life.

Of course, just like with any other situation when going into labor or planning a delivery, you should talk to your doctor to make sure that delayed clamping is something that is a viable option for your situation. Since there are special circumstances that could get in the way of practicing delayed clamping, you want to make sure your baby is otherwise healthy before making this decision. If you have a premature baby, you can discuss delayed clamping with the doctor before delivery, and since it is not mainstream for preemies yet you will probably have to ask about it beforehand. Delayed clamping is becoming more common in the full-term baby population, but it still is something some doctors are hesitant to do, so if you would like this done, it is always best to make your wishes known beforehand. As with anything in the medical field, there are risks to delayed clamping, but that is typically just in the special circumstances cases, and no adverse effects have been seen by following the protocols put into place for this procedure.

Jeanne Rose
Jeanne Rose lives in Cincinnati, Ohio, and has been a freelance writer since 2010. She took Allied Health in vocational school where she earned her CNA/PCA, and worked in a hospital for 3 years. Jeanne enjoys writing about science, health, politics, business, and other topics as well.


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