Effects of delayed cord clamping on residual placental blood volume, hemoglobin and bilirubin levels in term infants: a randomized controlled trial

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The objective of the study was to measure the effects of a 5-min delay (DCC) versus immediate cord clamping (ICC) on residual placental blood volume (RPBV) at birth, and hemoglobin and serum bilirubin at 24 to 48 h of age.


In this prospective randomized controlled trial, 73 women with term (37 to 41 weeks) singleton fetuses were randomized to DCC (≥5 min; n = 37) or ICC (< 20 s; n = 36).


Maternal and infant demographics were not different between the groups. Mean cord clamping time was 303 ± 121 (DCC) versus 23 ± 59 (ICC) s (P<0.001) with 10 protocol violations. Cord milking was the proxy for DCC (n = 11) when the provider could not wait. Infants randomized to DCC compared with ICC had significantly less RPBV (20.0 versus 30.8 ml kg1, P<0.001), higher hemoglobin levels (19.4 versus 17.8 g dl1, P = 0.002) at 24 to 48 h, with no difference in bilirubin levels.


Term infants had early hematological advantage of DCC without increases in hyperbilirubinemia or symptomatic polycythemia.

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