Researchers at the Hospital Italiano de Buenos Aires (Argentina) conducted a randomized controlled trial that measured serum ferritin and hemoglobin levels in term infants to assess the effect of cord clamping time on neonatal hematocrit values and clinical outcome. Out of the 276 mothers and their infants that participated in the initial study, 255 (92.4%) were followed up to six months; of these, 86 had their umbilical cords clamped within the first 15 seconds (early clamping), 83 at one minute, and 83 at three minutes. The pediatricians in charge of the evaluations during the follow-up period and the personnel in charge of the biochemical tests were blinded to the assignment group.
The results showed that the mothers and infants in the three groups had similar baseline characteristics; however, at six months of age, serum ferritin levels were significantly higher in the infants of the three minutes group than those the early group; no such difference was observed between the one minute group and the early group. Although there were no significant differences in mean hemoglobin values between the early, one-minute, and three minutes group, the prevalence of iron deficiency anemia was 3 times more frequent in the early clamping group (7.2%) than in three minutes group (2.4%). The study was published in the June 2010 issue of Archivos Argentinos de Pediatria.
"Delayed umbilical cord clamping at three minutes significantly increases serum ferritin levels in infants at 6 months of age,” concluded lead author Jose Ceriani Cernadas, M.D., and colleagues of the neonatology service.
At birth, the placenta, and umbilical cord start to contract, pumping blood toward the newborn. After equilibration, the cord's pulse ceases and blood flow from mother to newborn stops. Delaying clamping of the umbilical cord for at least 30 seconds reduces incidences of intraventricular hemorrhage, late on-set sepsis, anemia, and the need for blood transfusions. Another potential benefit of delayed cord clamping is ensuring that the baby receives the complete retinue of clotting factors, as well as umbilical cord blood (UCB)-derived stem cells, known to be pluripotent.
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