| Late vs early clamping of the umbilical cord in full-term neonates: systematic review and meta-analysis of controlled trials. | |
| | |
MedLine Citation:
|
PMID: 17374818 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
CONTEXT: With few exceptions, the umbilical cord of every newborn is clamped and cut at birth, yet the optimal timing for this intervention remains controversial. OBJECTIVE: To compare the potential benefits and harms of late vs early cord clamping in term infants. DATA SOURCES: Search of 6 electronic databases (on November 15, 2006, starting from the beginning of each): the Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Neonatal Group trials register, the Cochrane library, MEDLINE, EMBASE, and CINHAL; hand search of secondary references in relevant studies; and contact of investigators about relevant published research. STUDY SELECTION: Controlled trials comparing late vs early cord clamping following birth in infants born at 37 or more weeks' gestation. DATA EXTRACTION: Two reviewers independently assessed eligibility and quality of trials and extracted data for outcomes of interest: infant hematologic status; iron status; and risk of adverse events such as jaundice, polycythemia, and respiratory distress. DATA SYNTHESIS: The meta-analysis included 15 controlled trials (1912 newborns). Late cord clamping was delayed for at least 2 minutes (n = 1001 newborns), while early clamping in most trials (n = 911 newborns) was performed immediately after birth. Benefits over ages 2 to 6 months associated with late cord clamping include improved hematologic status measured as hematocrit (weighted mean difference [WMD], 3.70%; 95% confidence interval [CI], 2.00%-5.40%); iron status as measured by ferritin concentration (WMD, 17.89; 95% CI, 16.58-19.21) and stored iron (WMD, 19.90; 95% CI, 7.67-32.13); and a clinically important reduction in the risk of anemia (relative risk (RR), 0.53; 95% CI, 0.40-0.70). Neonates with late clamping were at increased risk of experiencing asymptomatic polycythemia (7 studies [403 neonates]: RR, 3.82; 95% CI, 1.11-13.21; 2 high-quality studies only [281 infants]: RR, 3.91; 95% CI, 1.00-15.36). CONCLUSIONS: Delaying clamping of the umbilical cord in full-term neonates for a minimum of 2 minutes following birth is beneficial to the newborn, extending into infancy. Although there was an increase in polycythemia among infants in whom cord clamping was delayed, this condition appeared to be benign. |
| | |
Authors:
|
Eileen K Hutton; Eman S Hassan |
Related Documents
:
|
7155478 - Vasopressin concentration in cord blood: correlation with method of delivery and cord ph. 21077728 - Obstetrical risk factors for focal intestinal perforation in very low birth weight infa... 3653788 - Postnatal changes in colloid osmotic pressure in premature infants: in healthy infants,... 23303428 - Vitamin d status of exclusively breastfed infants aged 2-3 months. 16682838 - Treatment of post-partum thyrotoxicosis. 9523068 - Postmortem identifications of remains. |
Publication Detail:
|
Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
|
Title: JAMA : the journal of the American Medical Association Volume: 297 ISSN: 1538-3598 ISO Abbreviation: JAMA Publication Date: 2007 Mar |
Date Detail:
|
Created Date: 2007-03-21 Completed Date: 2007-03-23 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7501160 Medline TA: JAMA Country: United States |
Other Details:
|
Languages: eng Pagination: 1241-52 Citation Subset: AIM; IM |
Affiliation:
|
Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario. huttone@mcmaster.ca |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Anemia Constriction Delivery, Obstetric* / methods Fetal Blood Humans Infant, Newborn / blood Jaundice, Neonatal Ligation Polycythemia Risk Term Birth Time Factors Umbilical Cord* |
| Comments/Corrections | |
Comment In:
|
JAMA. 2007 Mar 21;297(11):1257-8
[PMID:
17374821
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Eligibility criteria of randomized controlled trials published in high-impact general medical journa...
Next Document: When you look matters: the effect of assessment schedule on progression-free survival.