Delayed cord clamping significantly reduces mortality before discharge compared to immediate cord clamping.

The study summary includes the following:

• Two thousand three hundred sixty-nine records were identified, and 48 randomised trials were eligible.
• They included individual participant data on 6367 infants (3303 male, 2667 female, two intersex, and 395 missing data). D
• Unlike immediate cord clamping, deferred cord clamping reduced death before discharge with an odds ratio of 0·68.
• For umbilical cord milking compared with immediate cord clamping, no clear evidence was found of a difference in death before discharge with OR 0·73.
• For umbilical cord milking compared with deferred cord clamping, no clear evidence was found of a difference in death before discharge.
• They found no evidence of subgroup differences for the primary outcome, including gestational age, delivery type, multiple births, study year, and perinatal mortality.

Interpreting further, they said, Our study provided high-certainty evidence that deferred cord clamping reduces death before discharge in preterm infants. This effect is consistent across several participant-level and trial-level subgroups.

They added that these results will inform international treatment recommendations.

Australian National Health and Medical Research Council funded the study.

Reference:

Seidler et al. Deferred cord clamping, cord milking, and immediate cord clamping at preterm birth: a systematic review and individual participant data meta-analysis. The Lancet, 402(10418), 2209–2222.