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
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
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