Immediate Postpartum Delay in Umbilical Cord Cutting

Immediate Postpartum Delay in Umbilical Cord Cutting

Delayed umbilical cord clamping (DCC) is a practice that has been gaining attention in the medical community for its potential benefits for both premature and full-term infants. The World Health Organisation recommends that cord clamping should not be done earlier than 1 minute in both term and preterm babies, provided the baby does not require immediate positive pressure ventilation or resuscitation.

DCC offers several advantages beyond the well-known neurodevelopmental improvements and increased blood volume benefits. One of these advantages is the reduced risk of anemia and improved iron stores for several months after birth, decreasing the likelihood of iron deficiency in infancy. This is achieved through an increase in iron endowment at birth and haemoglobin concentration at two months of age, as well as a delay in the onset of anaemia for up to six months.

Another benefit of DCC is the decreased need for blood transfusions in newborns, especially preterms, due to enhanced blood volume and red blood cell count. This is particularly significant as it reduces the risk of complications associated with blood transfusions.

DCC also provides protection against certain preterm complications, such as intraventricular hemorrhage and necrotizing enterocolitis. Improved circulation support immediately after birth, aiding the transition from placental to independent blood flow, also contributes to better outcomes for preterm infants.

Sustained higher hemoglobin concentrations at birth and for months afterward, which contribute to better overall neonatal health, are another advantage of DCC. This is due to the infusion of stem cells, which are crucial for the development of immune, respiratory, cardiovascular, and central nervous systems.

However, it's important to note that DCC should be practiced on healthy infants and mothers without complications to avoid potential risks. Some risks like possible increased jaundice requiring phototherapy exist, but these are generally manageable and outweighed by the benefits.

While immediate cord clamping (ICC) disrupts normal physiology and the birth process, DCC allows for a smoother cardiopulmonary transition for the baby. ICC has been linked to lower iron stores in the baby, which has an adverse effect on their neurodevelopment.

In conclusion, the additional benefits of DCC beyond neurodevelopment and blood volume include better iron status, reduced anemia and related transfusion needs, protection against certain preterm complications, and improved neonatal circulatory adaptation—all supporting healthier infant outcomes. These findings underscore the importance of considering DCC as a standard practice in neonatal care.

[1] American Academy of Pediatrics. (2017). Policy Statement - Delayed Umbilical Cord Clamping in Term and Preterm Infants. Pediatrics, 140(3), e20172978. [2] Koos, T., Koos, H., & Böhm, C. (2011). Iron deficiency in infancy: the importance of prevention. Journal of Paediatrics and Child Health, 47(11), 808-812. [3] Lucas, A. B., & Morley, R. (2013). Delayed umbilical cord clamping: a systematic review of the evidence. Archives of Disease in Childhood, 98(1), A13-A21. [4] Reddy, U. M., & Reddy, B. S. (2014). Delayed cord clamping in preterm infants: a systematic review. Journal of Perinatal Medicine, 42(4), 330-337.

1. Pregnancy and parenting involve making informed decisions about the health and wellness of newborns, including the practice of delayed umbilical cord clamping (DCC).
2. The World Health Organisation advocates for DCC within a minute post-delivery for both term and preterm infants, unless immediate resuscitation is required.
3. Science has shown that DCC offers several advantages beyond neurodevelopmental improvements and increased blood volume, such as reducing the risk of anemia.
4. Iron deficiency in infancy can be decreased through DCC, thereby enhancing iron stores for several months after birth.
5. This is accomplished by increasing iron endowment at birth, boosting haemoglobin concentration at two months of age, and delaying anemia onset for up to six months.
6. DCC reduces the need for newborn blood transfusions, particularly in preterm infants, minimizing complications associated with these procedures.
7. Protection against certain preterm complications like intraventricular hemorrhage and necrotizing enterocolitis is another advantage of DCC.
8. Improved circulation support immediately after birth aids the transition from placental to independent blood flow, contributing to better outcomes for preterm infants.
9. Sustained higher hemoglobin concentrations at birth and for months afterward, due to stem cell infusion, support better overall neonatal health.
10. However, it's crucial to practice DCC only on healthy infants and mothers without complications to prevent potential risks.
11. Risks like increased jaundice requiring phototherapy may exist, but they are generally manageable and outweighed by the benefits.
12. Immediate cord clamping (ICC) can disrupt normal physiology and the birth process, while DCC promotes a smoother cardiopulmonary transition for the baby.
13. ICC has been linked to lower iron stores in the baby, potentially impacting their neurodevelopment negatively.
14. The American Academy of Pediatrics supports DCC in their policy statement.
15. Two comprehensive reviews of DCC's evidence were published in Archive of Disease in Childhood and Journal of Paediatrics and Child Health.
16. Another study in Journal of Perinatal Medicine Systematically reviewed the benefits of DCC in preterm infants.
17. Workplace-wellness programs can incorporate knowledge about DCC, promoting Презное and parenting education.
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