Delayed versus Immediate Cord Clamping for Term Infants: A Systematic Review

Abstract

Introduction: The optimal timing of umbilical cord clamping at birth is a topic of ongoing discussion. This review compares the neonatal and maternal outcomes of delayed cord clamping (DCC) versus immediate cord clamping (ICC) in term infants.

Methods: A search of the Cochrane Library and MEDLINE was conducted for RCTs comparing DCC (defined as >60 seconds) to ICC (<30 seconds) in term singleton pregnancies. Primary neonatal outcomes were hemoglobin concentration and serum ferritin at follow-up.

Results: The meta-analysis of 20 RCTs demonstrated that DCC was associated with significantly higher newborn hemoglobin levels and improved iron stores in infancy, as measured by serum ferritin at 3-6 months. DCC was also associated with a higher incidence of phototherapy for jaundice. No differences were seen in maternal outcomes like postpartum hemorrhage.

Discussion: DCC facilitates placental transfusion, which improves iron status in infancy and may be beneficial for neurodevelopment. The increased need for phototherapy is a manageable side effect.

Conclusion: Delayed cord clamping in term infants is beneficial, improving iron stores in infancy without increasing maternal risk.