Chinese Medical E-ournals Database
Adv Search
中华妇幼临床医学杂志(电子版)

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2020, Vol. 16 ›› Issue (04): 381 -385. doi: 10.3877/cma.j.issn.1673-5250.2020.04.002

Special Issue: ；

Forum

Effect of delayed cord clamping on neonates

Xiaotan Zhao1, Xiaohong Wen1,†(), Jinhua Huang1   

  1. 1. Department of Pediatrics, the First Affiliated Hospital of Anhui Medical University, Hefei First People′s Hospital, Hefei 230061, Anhui Province, China
  • Received:2020-02-11 Revised:2020-07-08 Published:2020-08-01
  • Corresponding author: Xiaohong Wen
  • About author:
    Corresponding author: Wen Xiaohong, Email:
  • Supported by:
    Program for Science and Technology Development of Anhui Province(1604a0802093)
HTML ( ) PDF ( )

Neonatal ligation of cord is a necessary medical procedure after delivery of fetus. At present, early cord clamping (ECC) is mostly used in clinical practice. However, many results of research at home and abroad show that delayed cord clamping (DCC) can increase effective circulating blood volume of neonates. It has a significant effect on increasing hemoglobin and iron reserve, reducing neonatal anemia, improving cardiovascular function and oxygenation, and enhancing immunity of neonates. No serious adverse effects of DCC on neonates and their mothers have been found. The author intends to elaborate on latest research status of clinical suitable umbilical cord ligation time, influencing factors of placental transfusion, the effect of taking DCC during delivery on neonates and their potential risks.

Key words: Delayed cord clamping, Hypovolemia, Hemoperfusion, Hemodynamics, Anemia, neonatal, Blood transfusion, autologous, Time management, ligation of umbilical cord, Infant, newborn
[1]
Katheria A, Hosono S. A new wrinkle: umbilical cord management (how, when, WHO) [J]. Semin Fetal Neonatal Med, 2018, 23(5): 321-326. DOI: 10.1016/j.siny.2018.07.003.
[2]
萧国良，张春一，张小庄. 延迟结扎脐带对新生儿及婴儿的影响[J/CD]. 中华妇幼临床医学杂志(电子版), 2015, 11(1): 99-101. DOI: 10.3877/cma.j.issn.1673-5250.2015.01.023.
[3]
钟瑞涵，李华凤. 延迟断脐对新生儿生理意义的研究现状[J/CD]. 中华妇幼临床医学杂志(电子版), 2019, 15(4): 363-367. DOI: 10.3877/cma.j.issn.1673-5250.2019.04.002.
[4]
Perlman JM, Wyllie J, Kattwinkel J, et al. Part 7, neonatal resuscitation: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations [J]. Circulation, 2015, 132(16 Suppl 1): S204-S241. DOI: 10.1161/CIR.0000000000000276.
[5]
McAdams RM, Backes CH, Hutchon DJ. Steps for implementing delayed cord clamping in a hospital setting [J]. Matern Health Neonatol Perinatol, 2015, 1: 10. DOI: 10.1186/s40748-015-0011-8.
[6]
Committee on Obstetric Practice. Committee opinion No. 684: delayed umbilical cord clamping after birth [J]. Obstet Gynecol, 2017, 129(1): e5-e10. DOI: 10.1097/AOG.0000000000001860.
[7]
World Health Organization. Guidelines on basic newborn resuscitation [M]. Geneva: World Health Organization, 2012: 21-24.
[8]
World Health Organization. Guideline: delayed umbilical cord clamping for improved maternal and infant health and nutrition outcomes [M]. Geneva: World Health Organization, 2014: 12-17.
[9]
Chiruvolu A, Elliott E, Rich D, et al. Effect of delay in cord clamping 45 versus 60 s on very preterm singleton infants [J]. Early Hum Dev, 2018, 119: 15-18. DOI: 10.1016/j.earlhumdev.2018.02.021.
[10]
Hooper SB, Binder-Heschl C, Polglase GR, et al. The timing of umbilical cord clamping at birth: physiological considerations [J]. Matern Health Neonatol Perinatol, 2016, 2: 4. DOI: 10.1186/s40748-016-0032-y.
[11]
Bhatt S, Alison BJ, Wallace EM, et al. Delaying cord clamping until ventilation onset improves cardiovascular function at birth in preterm lambs [J]. J Physiol, 2013, 591(8): 2113-2126. DOI: 10.1113/jphysiol.2012.250084.
[12]
Rabe H, Diazrossello JL, Duley L, et al. Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes [J]. Cochrane Database Syst Rev, 2012, (8): CD003248. DOI: 10.1002/14651858.CD003248.pub3.
[13]
Song D, Jegatheesan P, Desandre G, et al. Duration of cord clamping and neonatal outcomes in very preterm infants [J]. PLoS One, 2015, 10(9): e0138829. DOI: 10.1371/journal.pone.0138829.
[14]
Vain NE, Satragno DS, Gorenstein AN, et al. Effect of gravity on volume of placental transfusion: a multicentre, randomised, non-inferiority trial [J]. Lancet, 2014, 384(9939): 235-240. DOI: 10.1016/S0140-6736(14)60197-5.
[15]
Stevens GA, Finucane MM, De-Regil LM, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: a systematic analysis of population-representative data [J]. Lancet Global Health, 2013, 1(1): e16-e25. DOI: 10.1016/S2214-109X(13)70001-9.
[16]
Raju TNK. Timing of umbilical cord clamping after birth for optimizing placental transfusion [J]. Current Opin Pediatr, 2013, 25(2): 180-187. DOI: 10.1097/MOP.0b013e32835d2a9e.
[17]
Kc A, Rana N, Målqvist M, et al. Effects of delayed umbilical cord clamping vs early clamping on anemia in infants at 8 and 12 months: a randomized clinical trial [J]. JAMA Pediatr, 2017, 171(3): 264-270. DOI: 10.1001/jamapediatrics.2016.3971.
[18]
McDonald SJ, Middleton P, Dowswell T, et al. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes [J]. Evid Based Child Health, 2014, 9(2): 303-397. DOI: 10.1002/ebch.1971.
[19]
Nouraie S, AMIRALIl Akbari S, Vameghi R, et al. The effect of the timing of umbilical cord clamping on hemoglobin levels, neonatal outcomes and developmental status in infants at 4 months old [J]. Iran J Child Neurol, 2019, 13(1): 45-55.
[20]
Askelöf U, Andersson O, Domellöf M, et al. Wait a minute? An observational cohort study comparing iron stores in healthy Swedish infants at 4 months of age after 10-，60- and 180-second umbilical cord clamping [J]. BMJ Open, 2017, 7(12): e017215. DOI: 10.1136/bmjopen-2017-017215.
[21]
Rana N, Kc A, Målqvist M, et al. Effect of delayed cord clamping of term babies on neurodevelopment at 12 months: a randomized controlled trial [J]. Neonatology, 2019, 115(1): 36-42. DOI: 10.1159/000491994.
[22]
Killion MM. Delayed umbilical cord clamping at birth: beneficial for all babies [J]. MCN Am J Matern Child Nurs, 2017, 42(4): 232. DOI: 10.1097/NMC.0000000000000351.
[23]
顾珩，刘春静，纪丽丽，等. 比较胎儿娩出后结扎脐带时机对铁储备的影响[J]. 临床和实验医学杂志，2016, 15(8): 810-812. DOI: 10.3969/j.issn.1671-4695.2016.08.032.
[24]
Niermeyer S. A physiologic approach to cord clamping: clinical issues [J]. Matern Health Neonatol Perinatol, 2015, 1: 21. DOI: 10.1186/s40748-015-0022-5.
[25]
Jelin AC, Zlatnik MG, Kuppermann M, et al. Clamp late and maintain perfusion (CLAMP) policy: delayed cord clamping in preterm infants [J]. J Matern Fetal Neonat Med, 2016, 29(11): 1705-1709. DOI: 10.3109/14767058.2015.1061496.
[26]
Polglase GR, Dawson JA, Kluckow M, et al. Ventilation onset prior to umbilical cord clamping (physiological-based cord clamping) improves systemic and cerebral oxygenationin preterm lambs [J]. PLoS One, 2015, 10(2): e0117504. DOI: 10.1371/journal.pone.0117504.
[27]
Fogarty M, Osborn DA, Askie L. Delayed vs early umbilical cord clamping for preterm infants a systematic review and Meta-analysis [J]. Am J Obstet Gynecol, 2018, 218(1): 1-18. DOI: 10.1016/j.ajog.2017.10.231.
[28]
Menget A, Mougey C, Thiriez G, et al. Advantage of delayed umbilical cord clamping in the newborn infant [J]. Arch Pediatr, 2013, 20(9): 1022-1027. DOI: 10.1016/j.arcped.2013.06.016.
[29]
JAYKKA S. Capillary erection and the structural appearance of fetal and neonatal lungs [J]. Acta Paediatr, 1958, 47(5): 484-500. DOI: 10.1111/j.1651-2227.1958.tb07664.x.
[30]
Wiberg N, Källén K, Olofsson P. Delayed umbilical cord clamping at birth has effects on arterial and venous blood gases and lactate concentrations [J]. BJOG, 2010, 115(6): 697-703. DOI: 10.1111/j.1471-0528.2008.01708.x.
[31]
Chiruvolu A, Qin H, Nguyen ET, et al. The effect of delayed cord clamping on moderate and early late-preterm infants [J]. Am J Perinatol, 2018, 35(3): 286-291. DOI: 10.1055/s-0037-1607222.
[32]
Armanian AM, Tehrani HG, Ansari M, et al. Is " Delayed umbilical cord clamping" beneficial for premature newborns? [J]. Int J Pediatr, 2017, 5(5): 4909-4918. DOI: 10.22038/ijp.2016.7909.
[33]
Vali P, Mathew B, Lakshminrusimha S. Neonatal resuscitation: evolving strategies [J]. Matern Health Neonatol Perinatol, 2015, 1: 4. DOI: 10.1186/s40748-014-0003-0.
[34]
Ceriani JM. Stem cell transfer in newborn infants through placental transfusion via delayed umbilical cord clamping [J]. Arch Argent Pediatr, 2016, 114(6): 498-499. DOI: 10.5546/aap.2016.eng.498.
[35]
Sanberg PR, Park DH, Borlongan CV. Stem cell transplants at childbirth [J]. Stem Cell Rev Rep, 2010, 6(1)：27-30. DOI: 10.1007/s12015-009-9108-7.
[36]
Mercer JS, Vohr BR, Mcgrath MM, et al. Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial [J]. Pediatrics, 2006, 117(4): 1235-1242. DOI: 10.1542/peds.2005-1706.
[37]
Lawton C, Acosta S, Watson N, et al. Enhancing endogenous stem cells in the newborn via delayed umbilical cord clamping [J]. Neural Regen Res, 2015, 10(9): 1359-1362. DOI: 10.4103/1673-5374.165218.
[38]
Berglund SK, Torres-Espínola FJ, García-Valdés L, et al. The impacts of maternal iron deficiency and being overweight during pregnancy on neurodevelopment of the offspring [J]. Br J Nutr, 2017, 118(7): 533-540. DOI: 10.1017/S0007114517002410.
[39]
Vaivada T, Gaffey MF, Bhutta ZA. Promoting early child development with interventions in health and nutrition: a systematic review [J]. Pediatrics, 2017, 140(2): e20164308. DOI: 10.1542/peds.2016-4308.
[40]
Mercer JS, Erickson-Owens DA, Vohr BR, et al. Effects of placental transfusion on neonatal and 18 month outcomes in preterm infants: a randomized controlled trial [J]. J Pediatr, 2016, 168: 50-55.e1. DOI: 10.1016/j.jpeds.2015.09.068.
[41]
Mercer JS, Erickson-Owens DA, Deoni SCL, et al. Effects of delayed cord clamping on 4-month ferritin levels, brain myelin content, and neurodevelopment: a randomized controlled trial [J]. J Pediatr, 2018, 203: 266-272.e2. DOI: 10.1016/j.jpeds.2018.06.006.
[42]
Andersson O, Lindquist B, Lindgren M, et al. Effect of delayed cord clamping on neurodevelopment at 4 years of age: a randomized clinical trial [J]. JAMA Pediatr, 2015, 169(7): 631-638. DOI: 10.1001/jamapediatrics.2015.0358.
[43]
QianY, Ying X, Wang P, et al. Early versus delayed umbilical cord clamping on maternal and neonatal outcomes [J]. Arch Gynecol Obstet, 2019, 300(3): 531-543. DOI: 10.1007/s00404-019-05215-8.
[44]
Chen X, Li X, Chang Y, et al. Effect and safety of timing of cord clamping on neonatal hematocrit values and clinical outcomes in term infants: a randomized controlled trial [J]. J Perinatol, 2018, 38(3): 251-257. DOI: 10.1038/s41372-017-0001-y.
[45]
Mercer JS, Erickson-Owens DA, Collins J, et al. Effects of delayed cord clamping on residual placental blood volume, hemoglobin and bilirubin levels in term infants: a randomized controlled trial [J]. J Perinatol, 2017, 37(3): 260-264. DOI: 10.1038/jp.2016.222.
[46]
Zahir F, Rabbani G, Khan RH, et al. The pharmacological features of bilirubin: the question of the century [J]. Cell Mol Biol Lett, 2015, 20(3): 418-447. DOI: 10.1515/cmble-2015-0012.
[47]
Daskalakis G, Papapanagiotou A, Siristatidis C, et al. The influence of delayed cord clamping and cord milking on inflammatory cytokines in umbilical vein and neonatal circulation [J]. Acta Obstet Gynecol Scand, 2018, 97(5): 624-628. DOI: 10.1111/aogs.13294.
[48]
Mohammad K, Tailakh S, Fram K, et al. Effects of early umbilical cord clamping versus delayed clamping on maternal and neonatal outcomes: a Jordanian study [J]. J Matern Fetal Neonatal Med, 2019: 1-7. DOI: 10.1080/14767058.2019.1602603.
[1] Bo Tang, Jiping Luo, Tao Zhou, Duo Huang, Tingqiong Liu, Yaping Chen, Wensheng Yue. Hemodynamics changes of the brachial artery to fingertip arterioles on the fistula side upper limb in hemodialysis patients with chronic renal failure[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(12): 1276-1281.
[2] Shujie Wei, Pinjing Hui, Yafang Ding, Bai Zhang, Yanhong Yan, Peng Zhou, Yabo Huang. Evaluation of cerebral hemodynamics in patients with unilateral internal carotid artery occlusion undergoing superficial temporal artery-middle cerebral artery bypass[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1046-1055.
[3] Xiaoyu Li, Qing Jiang, Haiqin Tang, Jingzhi Luo. Clinical study of perioperative comprehensive management in ERCP +LC treatment of patients with choledocholithiasis complicated with acute cholangitis[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 57-60.
[4] Fengyi Li, Ruofan Li, Xu Gao, Chaofan Zhang. Effect of target-directed liquid intervention on postoperative hemodynamics and gastrointestinal function recovery in elderly patients with gastrointestinal tumors[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 29-32.
[5] Hebei Ding, Xun Wang, Weiguo Chen. Comparison of application of sevoflurane inhalation anesthesia and propofol intravenous anesthesia in pediatric indirect inguinal hernia surgery[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(05): 570-574.
[6] Xianfeng Li, Yi He, Zhenyong Cheng, Guokui Deng, Bo Hu, Hong Xie, Li Wang, Xiaoyan Wang, Xiaoming Li. Effect of dexmedetomidine on hemodynamics and anesthesia resuscitation in patients undergoing laparoscopic inguinal hernia repair[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(04): 437-441.
[7] Minmin Peng, Xiaobin Yang, Ya'nan Rui. Application of oxycodone combined with sufentanil in laparoscopic hernia repair surgery[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(02): 218-222.
[8] Jianli Guo, Na Zhu, Fei Song, Guodong Chai. Application effect of sevoflurane inhalation combined with remifentanil anesthesia in laparoscopic hernia repair in children[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(02): 223-227.
[9] Xia Luo, Baomei Wang, Shujing Li, Ying Yang. Expression of serum PCSK9 in idiopathic pulmonary hypertension and its prognostic significance[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2024, 17(04): 585-589.
[10] Ying Wang, Yiheng Xue, Guoqin Liu. Methodology exploration of the reconstruction mechanisms of blood flow in descengding and sigmoid colon after high ligation of the IMA[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(04): 265-271.
[11] Shousen Wang, Shilong Fu, Liang Xian, Long Lin. Further understanding of the prevention mechanism and effects for intraoperative encephalocele by controlled decompression technique in patients with traumatic brain injury[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2024, 10(05): 257-262.
[12] Baoyu Yuan, Yixiang Guan, Dongliu Wang, Zheng Lu. Clinical efficacy of skull repair surgery at different timing in the treatment of craniocerebral trauma[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2024, 10(01): 35-41.
[13] Haowen Xie, Jianying Ding, Xiaoxia Liu, Yi Feng, Jing Yao. Effect of paravertebral nerve block on intraoperative blood flow，postoperative stress and rehabilitation quality of obese patients undergoing minimally invasive gastrectomy[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(06): 569-573.
[14] Qiong Yuan, Zhizhen Li, Shaorong Huang, Weixuan Sun. Effects of laparoscopic unilateral fallopian tube fenestration combined with methotrexate on ovarian reserve function and hemodynamics in tubal pregnancy patients[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(12): 1315-1319.
[15] Conghui Liu, Haoran He, Yinuo Huang, Feng Zhang, Fanyue Wang, Han Hao. Effect of dietary copper supplementation on the expression level of myocardial matrix metalloproteinase 2 and hemodynamics after myocardial infarction in rats[J]. Chinese Journal of Diagnostics(Electronic Edition), 2024, 12(03): 166-172.
Viewed
Full text


Abstract

Copyright © Chinese Medical Association, Chinese Medical Multimedia Press  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号