Epidemiology of preterm birth: Delayed cord clamping used to be taught and practisedBMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7477.1287 (Published 25 November 2004) Cite this as: BMJ 2004;329:1287
EDITOR—Tucker and McGuire point out that modern perinatal care and the specific interventions of antenatal steroids and exogenous surfactant have contributed to the improved outcomes for very preterm infants.1 As an obstetric registrar in Ninewells Hospital, Dundee, in the mid-1970s I was taught and practised delayed cord clamping at delivery of preterm infants. This measure has since been shown to reduce the severity of respiratory distress syndrome2 and neonatal morbidity.3 Despite the evidence of benefit, timing of clamping the cord was not included in the 27/28 week inquiry into stillbirths and deaths in infancy (CESDI) project as a standard of care.4 A recent postal survey of obstetricians regularly delivering preterm infants showed that only 47% practised delayed cord clamping.5 Neither is this measure specified by Tucker and Mcguire in their review article.
I agree that prevention of preterm birth, or the need for it, provided by an adequate research based treatment, must be the ultimate aim. When prevention is not possible, every measure that reduces the morbidity and mortality of the infant must be given. Currently this does not seem to be the case in the United Kingdom.
Competing interests None declared.