Waiting one minute after birth to clamp the umbilical cord of a preterm newborn could save the baby’s life, a new Australian study suggests.
According to the research, nine percent of babies whose cords were clamped immediately died, but only 6.4 percent of babies whose cords were clamped after 60 seconds died.
With about 15 million babies born early each year, the study’s authors estimate the practice could save as many as 100,000 additional lives annually.
The WHO already recommends that the optimal time to clamp the umbilical cord of any baby is one minute after birth, but this study is the first to provide a large sample of data proving that the practice crucial health benefits for preterm babies.
Waiting one minute to clamp the umbilical cords of preterm babies could save the lives of as many as 100,000 according to the authors of a new Australian study
Every year, an estimated one million babies die of complications related to being born early.
Preterm birth puts children at risk for developmental and brain disorders, heart, lung, vision, dental, hearing and immune system issues, and premature birth is the leading cause of death for children under five worldwide.
Dr Haywood Brown, a Duke University maternal-fetal health specialist and president of the American College of Obstetrics and Gynecology (ACOG) says that ‘delayed cord clamping clearly benefits the infant – born at term and preterm – but greatest benefits are for preterm infants.’
Preterm babies are born with less blood in their bodies than term babies.
Anemia, a temporary condition in which the blood does not have enough red blood cells, is common in preterm babies. All babies, but especially those born preterm, break down red blood cells more quickly than their bodies are able to reproduce them on their own.
The earlier a baby is born, the less fully developed and able to produce red blood cells it is.
Many preterm babies will require blood transfusions. For a baby with extremely low birth weights or born very early – 29 weeks or earlier – a blood transfusion is almost always required.
The blood left in the placenta can help to make up for a preterm baby’s blood deficiency.
Red blood cells are transferred to the baby from the mother through the umbilical cord while the baby develops. Some reports claim that delaying cord clamping can boost the babies blood volume by as much as one third, drastically reducing the likelihood the newborn will need a transfusion.
The blood that the infant gets from its mother contains iron, which is crucial to brain development. A mother’s blood also contains immunoglobulins, ‘antibodies that are conferred from the mother to the baby to prevent greater risk of infections and things like that,’ says Dr Brown.
The benefits of delayed cord clamping
Many preterm babies are born anemic. The leftover blood in the placenta that is transferred to them through the umbilical cord can help make up for their red blood cell deficiency.
The blood transferred from the placenta also contains iron, which is key to a baby’s healthy brain development.
A mother’s blood contains immunoglobulins, antibodies that help protect vulnerable preterm newborns from infections.
Overall, the longer a newborn is receiving oxygen, blood and nutrients from its mother, the easier its transition into the world is, and that transition is a particularly difficult one for babies born too soon.
The Australian study, which has been approved to be published in a forthcoming issue of the American Journal of Obstetrics and Gynecology, analyzed data on nearly 3,000 births that took place before 37 weeks of pregnancy in 18 clinical trials.
The researchers found that about 9 percent of preterm newborns died when the umbilical cord was clamped immediately after birth.
By comparison, only 6.4 percent of premature babies whose cords were clamped after one minute died, a reduction of almost one third.
Dr Brown says that ACOG recommends that the cord is clamped between 30 and 60 seconds after birth.
‘Data would probably suggest that there is no greater benefit after about 60 seconds,’ he says.
‘Basically, once the baby starts taking its first breaths,’ usually within the first minute after birth, ‘the lungs take over, the circulation changes and the amount of blood transferred through the cord really diminishes’ he says.
The study’s authors underscored the importance of adhering to the WHO’s guidelines on umbilical cord clamping in light of their findings.
‘This is so significant as it is such a simple technique, suitable for almost all preterm babies that helps saves lives,’ study co-author and University of Sydney professor Jonathan Morris told MedicalXpress.