All it takes is 45 seconds to improve fetal health, according to a new study. Delayed cord clamping for less than a minute may seem like a trivial choice, but not according to researchers at Providence St. Vincent’s Medical Center is Oregon. The hospital chose to change umbilical cord clamping procedures in January, 2010. This report is a comparison of infant outcomes based on that change. Information was collected via health records before and after the change went into effect.
Information used for the report was collected from nearly 500 infants. About 150 of the infants were born in the very low birth weight (VLBW) category. The remaining infants were low birth weight (LBW). Delayed umbilical cord clamping was used in 77 of the VLBW infant births and 172 of the LBW infant births.
VLBW infants saw the most improvement with delayed umbilical cord clamping. Infants scored higher on then Apgar test, measured higher on hematocrit tests and required resuscitation less often.  The LBW category showed higher hematocrit scores, but none of the other benefits passed on to this group of infants.
Immediate cord clamping has been the standard for decades, but new evidence shows it could be more of a habit than a practice based on medical study or benefit. According to the Neonatal Resuscitation program, doctors should delay umbilical cord clamping a minimum of one minute if no immediate medical attention is needed. For instance, if the infant is born healthy, with no complications or immediate resuscitation needs, the umbilical cord should stay intact a minimum of one minute. If the infant requires resuscitation, there is no evidence that delaying umbilical cord clamping is better than an immediate clamp and advanced medical care.
What researchers worry most about is the lack of clear guidelines on how and when to delay cord clamping. There is also missing information in terms of multiples and varying gestational ages. But, not all doctors and hospitals are waiting for clear cut instructions. According to study authors, the doctors at Providence St. Vincent’s in Portland are waiting a minute before clamping, no matter what.
Source: Kaempf, Joseph W. MD; Tomlinson, Mark W. MD; Kaempf, Andrew J. BS; Wu, YingXing MD; Wang, Lian MS; Tipping, Nicole RN; Grunkemeier, Gary PhD. Obstetrics & Gynecology. August, 2012.