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Question 1 Is delayed clamping of the umbilical cord in moderately preterm babies beneficial?
  1. Richard M Nicholl1,
  2. Stephanie Richards2,
  3. Sagarika Ray2,
  4. Rohit Gowda3
  1. 1Department of Evidence Based Medicine, Neonatal Unit, Northwick Park Hospital, Harrow, UK
  2. 2Northwick Park Hospital, Harrow, UK
  3. 3Neonatal Unit, Chelsea and Westminster Hospital, London, UK
  1. Correspondence to Dr Richard M Nicholl, Department of Evidence Based Medicine, Neonatal Unit, Northwick Park Hospital, Harrow HA1 3UJ, UK; richard.nicholl{at}nwlh.nhs.uk

http://dx.doi.org/10.1136/adc.2009.176297

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    You are the admitting neonatal registrar. A baby delivered at 32 weeks’ gestation by caesarean section because of pregnancy induced hypertension has a haemoglobin of 17 g/dl and haematocrit (HCt) of 62. The senior house officer comments that the obstetrician had delayed clamping of the umbilical cord prior to handing the baby over “as it would be good for the baby”.

    The baby is well on admission, requiring only special care and has an uneventful stay prior to hospital discharge.

    Structured clinical question

    Is there any evidence that in preterm babies [patient] delayed cord clamping [intervention] versus immediate cord clamping [comparison] confers benefit [outcome]?

    Search strategy and outcome

    The keywords “umbilical cord” and “clamp” were used. We searched for randomised control trials which looked at early (ECC) versus delayed cord clamping (DCC) in preterm babies.

    Primary sources

    PubMed (January 1993 to March 2008) and Embase databases (January 1993 to March 2008).

    Secondary sources

    The Cochrane Library.

    Four randomised controlled trials (RCTs) and one systematic review were identified for further appraisal. See table 1.

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    Table 1

    Is delayed …

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    Footnotes

    • Competing interests None.

    • Provenance and peer review Commissioned; externally peer reviewed.

    • This paper was presented as an oral abstract at the 21st European Congress of Perinatal Medicine, Istanbul, Turkey, September 2008.