The article below summarizes a roundtable discussion of a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed:
Upadhyay A, Gothwal S, Parihar R, et al. Effect of umbilical cord milking in term and near term infants: randomized control trial. Am J Obstet Gynecol 2013;208:120.e1-6.
Discussion Questions
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What was the study design?
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What interventions were under investigation?
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What outcomes were measured?
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What guidelines exist for reporting studies?
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What were the results of this study?
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How do the results pertain to clinical practice?
Optimal timing of cord clamping is a subject that has garnered much interest recently. Potential benefits of delayed cord clamping, occurring some 30-60 seconds after birth rather than the usual 15-20 seconds after birth, include increases in newborns’ blood volume and hemoglobin level In December, 2012, the American Congress of Obstetricians and Gynecologists, with the assistance and subsequent endorsement of the American Academy of Pediatrics, issued a Committee Opinion that recommended delayed cord-clamping for preterm infants—though not for term infants. This guidance was based on systematic reviews of the available data, which revealed that intraventricular hemorrhage was reduced by nearly 50% in preterm infants when cord clamping was delayed and the neonate was held at a level below that of the placenta. A reduced need for transfusion was noted as well. While term infants had increased levels of hemoglobin and ferritin when clamping was delayed, they also had an increase in hyperbilirubinemia.
See related article, page 120
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