Benefits of late cord clamping

The benefits of delayed umbilical cord clamping in newborns they are several, both for the mother and for the baby, in the short and long term. This practice is part of the recommendations in the first hour of life of the baby.

In the document entitled "Beyond Survival: Comprehensive practices during childbirth care, beneficial for the nutrition and health of mothers and children", of the Pan American Health Organization (the regional office of the World Health Organization ), a section dedicated to the recommendations about the umbilical cord cut is offered.

He optimal time to tie the cord of all newborns is when the umbilical cord circulation has ceased, is flattened and without a pulse (approximately 3 minutes or more after birth). Doing it before this time deprives mother and baby of certain benefits.

As a summary of the advantages that the late cutting of the cord supposes, we highlight the following:

Immediate benefits of late cutting of the cord

For preterm or low birth weight newborns:

Recent studies show that premature cord cutting has immediate negative effects that are more evident in premature infants and in newborns of low birth weight due to their initial lower feto-placental blood volume and slower cardiorespiratory adaptation.

  • It reduces the risk of intraventricular hemorrhage and late onset sepsis (although more studies are needed to determine the relationship between cord cut time and sepsis).
  • Decreases the need for blood transfusion due to anemia or low blood pressure; the need for surfactant; The need for mechanical ventilation. Therefore, the delay in cord clamping can be particularly important in places with limited resources, where there is limited access to expensive technology.
  • In the baby they increase: hematocrits, hemoglobin, blood pressure, cerebral oxygenation and red blood cell flow.
  • For full-term newborns:

    • It provides an adequate volume of blood and iron stores at birth.
    • A recent meta-analysis concludes that late cutting of the cord is not related to an increased risk of neonatal complications, the two most studied being polycythemia and jaundice, and neither did it significantly increase the average value of serum bilirubin (these were some of the reasons why the practice of late cutting was neglected throughout the twentieth century). However, we must point out that there is some controversy in this regard, because there are studies that indicate the evidence that late clamping and cutting could expose newborns to an increased risk of polycythemia, hyperbilirubinemia and other neonatal disorders, as indicated by World Health Organization itself.

    For the mothers:

    Although there are few studies related to the moment of umbilical cord clamping that have incorporated results on the evolution of the mother, some benefits are assumed.

    It has been speculated that a less distended placenta with less blood may be easier to be expelled from the uterine cavity. The lower amount of blood may be due to late cord cutting or placental drainage.

    From studies on "placental drainage," a placenta with less blood shortens the third period of labor and decreases the incidence of placental retention.

    However, according to some reviews of clinical studies on the risk of puerperal haemorrhage, no significant differences were observed between groups of women in whom early clamping and cutting and late clamping and cutting were performed.

    Long-term benefits of late cord cutting

    For preterm or low birth weight newborns:

    Increase hemoglobin at 10 weeks of age. Hemoglobin is a protein that contains iron and gives the blood a red color. It is found in red blood cells and is responsible for transporting oxygen through the blood from the lungs to the tissues.

    For full-term newborns:

    • It improves the hematological state (hemoglobin and hematocrit) at two to four months of age.
    • It improves iron status until six months of age, which has proven important in preventing iron deficiency and anemia during childhood. The iron reserves of birth are a strong predictor of the subsequent state of iron and anemia during childhood.

    Even so, there are aspects that still have to be investigated and certain controversies about possible risks of late cutting of the cord. In 1996 the WHO in its Guide to normal delivery care states that:

    Although there is currently insufficient evidence to decide on late or early clamping, it is clear that this issue deserves more attention.

    In any case, although more studies will be needed, we have seen the conclusions in more recent documents about numerous benefits of late ligation of the umbilical cord for the baby that do seem unquestionable and to those who, as long as the delivery develops under normal conditions, we should not give up due to hospital routine issues.

    Video: Delayed Cord Clamping (March 2024).