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Time to Implement Delayed Cord Clamping

McAdams, Ryan M. MD

doi: 10.1097/AOG.0000000000000122
Contents: Labor Management: Current Commentary

Immediate umbilical cord clamping after delivery is routine in the United States despite little evidence to support this practice. Numerous trials in both term and preterm neonates have demonstrated the safety and benefit of delayed cord clamping. In premature neonates, delayed cord clamping has been shown to stabilize transitional circulation, lessening needs for inotropic medications and reducing blood transfusions, necrotizing enterocolitis, and intraventricular hemorrhage. In term neonates, delayed cord clamping has been associated with decreased iron-deficient anemia and increased iron stores with potential valuable effects that extend beyond the newborn period, including improvements in long-term neurodevelopment. The failure to more broadly implement delayed cord clamping in neonates ignores published benefits of increased placental blood transfusion at birth and may represent an unnecessary harm for vulnerable neonates.

Based on multiple trials that have consistently demonstrated safety and benefit in term and preterm neonates, delayed cord clamping should now become standard practice.

Department of Pediatrics, University of Washington, Seattle, Washington.

Corresponding author: Ryan M. McAdams, MD, Department of Pediatrics, Division of Neonatology, University of Washington, Box 356320, Seattle, WA 98195-6320; e-mail:

The author thanks Paul Mann for helpful and critical comments on the manuscript.

Financial Disclosure The author did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.