Cord clamp delay 'good for babies'
By JILL PENGELLEY
27apr06

http://www.theadvertiser.news.com.au/common/story_page/0,5936,18941393%255E2682,00.html 

A 30-SECOND delay in clamping a premature newborn's umbilical cord protects against bleeding in the brain and infection, groundbreaking new research shows.

The study, involving 72 babies, could prompt a reassessment of the standard practice of clamping immediately after birth.

Delayed clamping has been shown to increase the volume of blood transferred to the baby from the placenta.

Researchers from the University of Rhode Island, in the U.S., followed 36 babies assigned to immediate cord clamping and 36 assigned to delayed cord clamping.

All were less than 32 weeks' gestation. Their prematurity meant they were at increased risk of brain haemorrhage and infection. In the weeks after birth, 36 per cent of the immediate group had suffered bleeding in the brain, compared with 14 per cent of the delayed group.

Nine of the immediate group and none of the delayed group developed infections while in intensive care.

"It may be that the small amounts of additional blood preterm infants obtain by delaying cord clamping helps to stabilise cerebral blood flow and provide additional stem cells to establish adequate immunocompetence," the report in this month's American Pediatrics journal says.

A similar study involving full-term newborns is planned. A South American study published in the same edition of the journal shows blood iron levels increased in babies whose cords were clamped up to three minutes after birth.

The director of neo-natal intensive care at Flinders Medical Centre, Associate Professor Peter Marshall, said several small studies had pointed to the benefits of delayed cord clamping, but practices were unlikely to change without the definitive larger study.

He said delaying clamping was "probably going to turn out to be important" in premature babies, but was not always possible.

Adelaide obstetrician Dr Chris Hughes, spokesman for the Royal Australian College of Obstetricians and Gynaecologists, said the findings needed to be reproduced, but such studies would be watched with interest.