Delay Umbilical Cord Clamping in Pre Term Babies

According to a revolutionary new study by a University of Rhode Island professor of nursing, delaying the clamping the umbilical cords of pre term babies can protect them from brain hemorrhages as well as infections.

The results of the federally funded study by Judith Mercer, a clinical professor of nursing and certified nurse-midwife, were published in the latest issue of Pediatrics, the journal of the American Academy of Pediatrics.

"These findings are very important because in most U.S. hospitals, umbilical cords are clamped immediately," Mercer said. "This is an easy, no-cost procedure that increases the amount of blood the baby receives at birth. This blood gives the baby more red blood cells to carry oxygen and has high concentrations of beneficial stem cells."

The three-year study, conducted at Women and Infants Hospital in Providence, was funded by a $392,000 National Institute of Nursing Research grant, a division of the National Institutes of Health.

Seventy-two mother-infant pairs participated during a 16-month period. Each baby was born before 32 weeks—a typical baby is born at 40 weeks-- and weighed less than 3 pounds. In this study, babies were randomly assigned to either immediate cord clamping or delayed cord clamping. In the immediate group, babies had their cords clamped between 5 and 10 seconds after birth. In the delayed group, cords were clamped at 30 to 45 seconds after birth and the babies were lowered below the mother to help them get their blood more quickly.

In the study, Mercer found that the infants in the delayed cord clamping group had significantly lower rates of intraventricular hemorrhage (bleeding in the brain) and blood infections, which occur more than 72 hours after birth. She said infection and bleeding in the brain are associated with developmental delays and conditions such as cerebral palsy.

Infants in the delayed clamping group were also less likely to have blood infections. All the babies who had infections had their cords clamped immediately.

The delay in cord clamping had the most dramatic effect on boys. Eight boys whose umbilical cords were clamped immediately suffered from bleeding in the brain while only two did in the delayed group. Similarly, six boys in the immediate group had infections while none did in the delayed group. Boys born preterm are at the greatest risk for death and disabilities of any children.

Mercer said the findings are important because brain hemorrhage and infections may be a result of blood volume loss at birth and immune system compromise caused by the loss of protective stem cells. "We think that babies with delayed clamping have increased blood flow from the cord which helps to stabilize the cardiovascular system and results in less bleeding in the brain," Mercer said.

"I have been on a quest during the 30 years of my practice to learn about the benefits of delayed cord clamping. Next, we hope to study the effects of delayed clamping in full-term infants."