The timing of umbilical cord clamping is a subject of controversy and debate and varies according to clinical policy and practice at each hospital. “Early” cord clamping generally refers to cord clamping carried out in the first 60 seconds after birth, whereas “delayed” umbilical cord clamping refers to cord clamping performed more than one minute after birth, or when cord pulsation has stopped.
In most cases, umbilical cord clamping is performed within 15 to 20 seconds after birth, however several studies have shown that delaying cord clamping by two to three minutes results in a larger transfer of placental blood to the infant and expands the blood volume in the newborn by 30% to 40%. The World Health Organization has endorsed delayed cord clamping for improving immediate and long-term outcomes for infants and mothers.
Data access has been approved for a population-based study led by Neda Razaz, a Research Fellow at the University of British Columbia, to examine the effect of early versus delayed cord clamping on the five minute Apgar score. The project will also attempt to confirm previous findings which showed an association between a five minute Apgar score of nine (compared with a five minute Apgar score of ten) and higher rates of developmental vulnerability at five years of age.
“Despite overwhelming evidence that delayed cord clamping has beneficial effects for infants and mothers, the practice of delayed cord clamping has not been widely adopted, possibly due to the lack of knowledge regarding long-term outcomes,” says Dr. Razaz. “Delayed clamping of the umbilical cord is a physiological and inexpensive means of enhancing an infant’s iron stores and pulmonary circulation that may have implications for improving long-term developmental outcomes.”
The results of this research will inform obstetric practice and will have a direct impact on clinical decisions related to management of the third stage of labour.
PopData will be linking data from the BC Ministry of Health, BC Vital Statistics Agency, Perinatal Services BC and Statistics Canada with Early Development Instrument data from the Human Early Learning Partnership.
