Intended for healthcare professionals


Delayed cord clamping and improved infant outcomes

BMJ 2011; 343 doi: (Published 15 November 2011) Cite this as: BMJ 2011;343:d7127
  1. Patrick van Rheenen, consultant paediatrician
  1. 1University of Groningen, University Medical Centre Groningen, 9700 RB Groningen, Netherlands
  1. p.f.van.rheenen{at}

Enough evidence exists to encourage a routine change in practice

Cord clamping and cutting is a common procedure but little agreement exists among doctors about the optimal timing. Cord clamping takes place in the third stage of labour, which is defined as the period from expulsion of the fetus to the expulsion of the placenta. Early clamping in term babies is sometime between 10 seconds and one minute after birth, whereas delayed clamping is between two minutes after birth and cessation of cord pulsations. In the linked randomised trial (doi:10.1136/bmj.d7157), Andersson and colleagues compare the effects of early versus delayed cord clamping on infant iron status at 4 months of age in a European setting.1

Management of the third stage of labour has typically focused on women and prevention of postpartum haemorrhage. A systematic review published in 2000 found that active management involving the use of oxytocics, early cord clamping, and controlled cord traction was superior to expectant management in terms of maternal blood loss.2 For this reason, early clamping was accepted into obstetric practice without much consideration.

Another systematic review published in 2008 studied the effects of different cord clamping times …

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