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Delayed cord clamping reduces anemia at 8 and 12 months of age (2017-01-23)

Delayed umbilical cord clamping has been shown to improve iron stores in infants to 6 months of age. However, delayed cord clamping has not been shown to prevent iron deficiency or anemia after 6 months of age.

After delivery, fetoplacental blood is transfused to the newborn, augmenting the infant’s blood volume by 30% to 40% (roughly 25-30 mL/kg), if early cord clamping is avoided.
Neonatal benefits include better cardiopulmonary adaptation and higher hemoglobin concentrations to 2 to 3 months of age.

The blood transfused can contribute with 75 mg of iron and has been shown to increase iron stores and prevent iron deficiency in early infancy, to 6 months of life.

In theory, this increased store of iron could help to prevent iron deficiency and iron deficiency anemia later in infancy. This possibility was not shown in a randomized clinical trial among infants aged 12 months in Sweden, whereas an observational trial performed in Peru found a 16% reduction in anemia at 8 months after a hospital policy change. Convincing evidence is still lacking regarding the effect of delayed cord clamping on infants’ iron stores after 6 months of age.

This randomized clinical trial included 540 late preterm and term infants born vaginally at a tertiary hospital in Kathmandu, Nepal, from October 2 to November 21, 2014.
Follow-up included blood levels of hemoglobin and ferritin at 8 and 12 months of age and was completed on December 11, 2015. Analysis was based on intention to treat.

Additional research may be needed to evaluate whether the optimal timing of cord clamping may be even later than 180 seconds (ie, at the delivery of the placenta).

For more information
The JAMA Pediatrics
Effects of Delayed Umbilical Cord Clamping vs Early Clamping on Anemia in Infants at 8 and 12 MonthsA Randomized Clinical Trial