Effects of Delayed Cord Clamping on Residual Placental Blood Volume, Hemoglobin and Bilirubin Levels in Term Infants: A Randomized Controlled Trial

OBJECTIVE: To measure the effects of a five-minute delay (DCC) versus immediate cord clamping (ICC) on residual placental blood volume (RPBV) at birth, and hemoglobin and serum bilirubin at 24 to 48 hours of age. STUDY DESIGN: In this prospective randomized controlled trial, seventy-three women with term (37 to 41 weeks) singleton fetuses were randomized to DCC (≥5 minutes; n=37) or ICC (<20 seconds; n=36). RESULTS: Maternal and infant demographics were not different between groups. Mean cord clamping time was 303 ± 121 (DCC) versus 23 ± 59 (ICC) seconds (p<0.001) with 10 protocol violations. Cord milking was the proxy for DCC (n = 11) when the provider could not wait. Infants randomized to DCC compared to ICC had significantly less RPBV (20.0 vs 30.8 mL/kg, p<0.001), higher hemoglobin levels (19.4 vs 17.8 g/dL, p=0.002) at 24 to 48 hours, with no difference in bilirubin levels. CONCLUSIONS: Term infants had early hematological advantage of DCC without increases in hyperbilirubinemia or symptomatic polycythemia.