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

OBJECTIVE: 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. STUDY DESIGN: 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). RESULTS: 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 TO 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 kg(-1), P < 0.001), higher hemoglobin levels (19.4 versus 17:8 g dl(-1), P=0.002) at 24 to 48 h, with no difference in bilirubin levels. CONCLUSION: Term infants had early hematological advantage of DCC without increases in hyperbilirubinemia or symptomatic polycythemia.