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Early versus delayed umbilical cord clamping in preterm infants

  1. Heike Rabe1,*,
  2. Graham J Reynolds2,
  3. Jose Luis Diaz-Rosello3

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 17 FEB 2010

Assessed as up-to-date: 30 JUN 2004

DOI: 10.1002/14651858.CD003248.pub2

Database Title

Additional Information

How to Cite

Rabe H, Reynolds GJ, Diaz-Rosello JL. Early versus delayed umbilical cord clamping in preterm infants. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD003248. DOI: 10.1002/14651858.CD003248.pub2.

Author Information

  1. 1

    Brighton and Sussex University Hospitals, Royal Sussex Country Hospital, Trevor Mann Baby Unit, Brighton, UK

  2. 2

    The Canberra Hospital, Department of Paediatrics and Child Health, Canberra, Australian Capital Territory, Australia

  3. 3

    Pan American Health Organization - World Health Organization, Montevideo, Uruguay

*Heike Rabe, Trevor Mann Baby Unit, Brighton and Sussex University Hospitals, Royal Sussex Country Hospital, Eastern Road, Brighton, BN2 5BE, UK. heike.rabe@bsuh.nhs.uk. hrabe@uni-muenster.de.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 17 FEB 2010

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Optimal timing for clamping of the umbilical cord at birth is unclear. Early clamping allows for immediate resuscitation of the newborn. Delaying clamping may facilitate transfusion of blood between the placenta and the baby.

Objectives

To delineate the short- and long-term effects for infants born at less than 37 completed weeks' gestation, and their mothers, of early compared to delayed clamping of the umbilical cord at birth.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (2 February 2004), the Cochrane Neonatal Group's Trials Register (2 February 2004), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2004, Issue 1), PubMed (1966 to 2 February 2004) and EMBASE (1974 to 2 February 2004). We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 30 November 2009 and added the results to the awaiting classification section

Selection criteria

Randomized controlled trials comparing early with delayed (30 seconds or more) clamping of the umbilical cord for infants born before 37 completed weeks' gestation.

Data collection and analysis

Three reviewers assessed eligibility and trial quality.

Main results

Seven studies (297 infants) were eligible for inclusion. The maximum delay in cord clamping was 120 seconds. Delayed cord clamping was associated with fewer transfusions for anaemia (three trials, 111 infants; relative risk (RR) 2.01, 95% CI 1.24 to 3.27) or low blood pressure (two trials, 58 infants; RR 2.58, 95% CI 1.17 to 5.67) and less intraventricular haemorrhage (five trials, 225 infants; RR 1.74, 95% CI 1.08 to 2.81) than early clamping.

Authors' conclusions

Delaying cord clamping by 30 to 120 seconds, rather than early clamping, seems to be associated with less need for transfusion and less intraventricular haemorrhage. There are no clear differences in other outcomes.

[Note: The 14 citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Early versus delayed umbilical cord clamping in preterm infants

Delayed cord clamping for babies born early improves their health.

In the womb, blood flows to and from the baby and the placenta bringing oxygen to the baby from the mother's blood. If the cord is left unclamped for a short time after the birth, some of the baby's blood from the placenta passes to the baby to help the flow of blood to the baby's lungs. In the review of studies on babies born prematurely, delaying cord clamping for just a very short time helped the babies to adjust to their new surroundings better. Further studies are needed on longer delays to see whether this brings even more benefits.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

早產兒中，比較提早或延遲將臍帶夾住

生產時，將臍帶夾住的適當時機並不清楚。提早夾住可以立即對新生兒進行復甦之動作，延遲夾住則可能有助於胎盤和嬰兒之間的血液輸送

目標

未滿37週出生之嬰兒，在生產時提早或延遲將臍帶夾住對於母親和嬰兒的短期與長期影響

搜尋策略

我們搜尋 Cochrane Pregnancy和Childbirth Group trials register (2004年2月2日)、Cochrane Neonatal Group trials register (2004年2月2日)、Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2004)、PubMed (1966年2004年2月2日)以及EMBASE (1974年2004年2月2日)

選擇標準

隨機控制試驗比較提早和延遲(30秒以上)將未滿37週出生之嬰兒的臍帶夾住

資料收集與分析

3位回顧者獨立評估適用性和試驗品質

主要結論

納入7篇研究、297名嬰兒。延遲夾住臍帶最久的時間是120秒。和提早夾住相比，延遲夾住臍帶比較少有因貧血而需輸血(3篇研究、111名嬰兒；RR為2.01, 95% CI為1.24 – 3.27)或低血壓(2研究、58名嬰兒；RR為 .58, 95% CI為1.17 – 5.67)，也較少腦室內出血(5篇研究、225名嬰兒；RR為 .74, 95% CI為1.08 – 2.81)

作者結論

延遲30 – 120秒夾住臍帶，與減少輸血需求和心室內出血有關。其他結果則無顯著差異

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

延遲夾住臍帶可以改善早產兒的健康。在子宮中，血液流往嬰兒再從嬰兒離開，胎盤將母親血液中之氧氣帶往嬰兒。如果在產後讓臍帶有一段時間先不夾住，胎盤中的一些嬰兒的血液可以流回到嬰兒體內，可幫助血液流到嬰兒的肺部。這些有關早產兒的研究之文獻回顧中，延遲一點時間夾住有助於嬰兒對週遭新環境適應更佳。需要後續研究探討延遲更久是否可以有更多助益

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