Also Noted

Delayed clamping of the umbilical cord after delivery results in placental transfusion. In children born vaginally, a 2- to 3-minute delay in clamping can increase the neonate’s blood volume by 20 to 30 mL/kg. The potential benefits and drawbacks of late cord clamping were assessed using meta-analysis. This validation study examined 15 controlled trials involving 1912 newborns. At age 2 to 6 months, those with delayed clamping (>2 minutes) demonstrated increased hematocrit, ferritin, and stored iron levels. Importantly, these children also had a clinically significant decrease in the risk of anemia (relative risk = 0.53; 95% confidence interval = 0.4 to 0.7). Newborns with late clamping were at increased risk for asymptomatic polycythemia, but no other adverse effects were noted. Of note, this study did not address the effect of the current practice of administering oxytocin at the end of labor, and an accompanying editorial does not recommend altering this practice.