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Photo by Meutia Chaerani
and Indradi Soemardjan
New research suggests that delayed umbilical cord clamping in full-term infants may confer some minor long-term benefits and, at the very least, does not pose any harm.
Delayed clamping did not appear to have a significant effect on most of the mental and physical measures assessed in the study.
It was associated with improved scores in fine-motor skills and social skills at age 4, but these effects only occurred in boys.
Researchers reported these results in JAMA Pediatrics alongside a related editorial.
Previous research has shown that delaying umbilical cord clamping by 2 to 3 minutes after delivery allows fetal blood remaining in the placental circulation to be transfused back to the newborn, and this is associated with improved iron status at 4 to 6 months of age.
However, there is a lack of knowledge regarding the long-term effects of delayed clamping. So policymakers have been hesitant about making clear recommendations regarding cord clamping in full-term infants.
To gain more insight, Ola Andersson, MD, PhD, of Uppsala University in Sweden, and his colleagues performed follow-up assessments of 263 children who were previously enrolled in a randomized trial of cord clamping in full-term infants born in a Swedish hospital.
The team assessed the effects of delayed cord clamping on childhood development at age 4. Delayed clamping (n=141) was defined as occurring 3 or more minutes after delivery, and early clamping (n=122) was defined as occurring 10 seconds or fewer after delivery.
The researchers evaluated child behavior and development using parents’ responses on the Ages and Stages Questionnaire, Third Edition (ASQ), which is used to assess communication, motor skills, and other measures; and the Strengths and Difficulties Questionnaire, which is used to score children’s emotional difficulties, hyperactivity, and other difficulties.
A blinded psychologist also assessed children’s scores on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III), which is used to assess IQ and similar measures, and the Movement Assessment Battery for Children (Movement ABC), which is used to assess manual dexterity and similar measures.
The researchers found no significant differences between the delayed and early clamping groups with regard to results on the WPPSI-III or the Movement ABC.
However, delayed clamping was associated with a significant improvement over early clamping in ASQ personal-social scores (adjusted mean difference [AMD]=2.8, P=0.006), fine-motor scores (AMD=2.1, P=0.03), and the Strengths and Difficulties Questionnaire prosocial subscale (AMD=0.5, P=0.05).
When the researchers assessed the children according to sex, they found that significant improvements associated with delayed clamping were only present in males.
Males in the delayed clamping group had significantly higher mean scores in tasks involving fine-motor function, including the WPPSI-III processing-speed quotient (AMD=4.2, P=0.02), the Movement ABC bicycle-trail task (AMD=0.8, P=0.03), and fine-motor scores on the ASQ (AMD=4.7, P=0.01). These boys also had significantly higher personal-social scores on the ASQ (AMD=4.9, P=0.004).
The researchers concluded that, although delayed cord clamping and early clamping resulted in similar overall neurodevelopment and behavior among 4-year-old children, there were differences in this study. And this suggests there are some positive, and no harmful, long-term effects of delayed cord clamping. 
Photo by Meutia Chaerani
and Indradi Soemardjan
New research suggests that delayed umbilical cord clamping in full-term infants may confer some minor long-term benefits and, at the very least, does not pose any harm.
Delayed clamping did not appear to have a significant effect on most of the mental and physical measures assessed in the study.
It was associated with improved scores in fine-motor skills and social skills at age 4, but these effects only occurred in boys.
Researchers reported these results in JAMA Pediatrics alongside a related editorial.
Previous research has shown that delaying umbilical cord clamping by 2 to 3 minutes after delivery allows fetal blood remaining in the placental circulation to be transfused back to the newborn, and this is associated with improved iron status at 4 to 6 months of age.
However, there is a lack of knowledge regarding the long-term effects of delayed clamping. So policymakers have been hesitant about making clear recommendations regarding cord clamping in full-term infants.
To gain more insight, Ola Andersson, MD, PhD, of Uppsala University in Sweden, and his colleagues performed follow-up assessments of 263 children who were previously enrolled in a randomized trial of cord clamping in full-term infants born in a Swedish hospital.
The team assessed the effects of delayed cord clamping on childhood development at age 4. Delayed clamping (n=141) was defined as occurring 3 or more minutes after delivery, and early clamping (n=122) was defined as occurring 10 seconds or fewer after delivery.
The researchers evaluated child behavior and development using parents’ responses on the Ages and Stages Questionnaire, Third Edition (ASQ), which is used to assess communication, motor skills, and other measures; and the Strengths and Difficulties Questionnaire, which is used to score children’s emotional difficulties, hyperactivity, and other difficulties.
A blinded psychologist also assessed children’s scores on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III), which is used to assess IQ and similar measures, and the Movement Assessment Battery for Children (Movement ABC), which is used to assess manual dexterity and similar measures.
The researchers found no significant differences between the delayed and early clamping groups with regard to results on the WPPSI-III or the Movement ABC.
However, delayed clamping was associated with a significant improvement over early clamping in ASQ personal-social scores (adjusted mean difference [AMD]=2.8, P=0.006), fine-motor scores (AMD=2.1, P=0.03), and the Strengths and Difficulties Questionnaire prosocial subscale (AMD=0.5, P=0.05).
When the researchers assessed the children according to sex, they found that significant improvements associated with delayed clamping were only present in males.
Males in the delayed clamping group had significantly higher mean scores in tasks involving fine-motor function, including the WPPSI-III processing-speed quotient (AMD=4.2, P=0.02), the Movement ABC bicycle-trail task (AMD=0.8, P=0.03), and fine-motor scores on the ASQ (AMD=4.7, P=0.01). These boys also had significantly higher personal-social scores on the ASQ (AMD=4.9, P=0.004).
The researchers concluded that, although delayed cord clamping and early clamping resulted in similar overall neurodevelopment and behavior among 4-year-old children, there were differences in this study. And this suggests there are some positive, and no harmful, long-term effects of delayed cord clamping.
Photo by Meutia Chaerani
and Indradi Soemardjan
New research suggests that delayed umbilical cord clamping in full-term infants may confer some minor long-term benefits and, at the very least, does not pose any harm.
Delayed clamping did not appear to have a significant effect on most of the mental and physical measures assessed in the study.
It was associated with improved scores in fine-motor skills and social skills at age 4, but these effects only occurred in boys.
Researchers reported these results in JAMA Pediatrics alongside a related editorial.
Previous research has shown that delaying umbilical cord clamping by 2 to 3 minutes after delivery allows fetal blood remaining in the placental circulation to be transfused back to the newborn, and this is associated with improved iron status at 4 to 6 months of age.
However, there is a lack of knowledge regarding the long-term effects of delayed clamping. So policymakers have been hesitant about making clear recommendations regarding cord clamping in full-term infants.
To gain more insight, Ola Andersson, MD, PhD, of Uppsala University in Sweden, and his colleagues performed follow-up assessments of 263 children who were previously enrolled in a randomized trial of cord clamping in full-term infants born in a Swedish hospital.
The team assessed the effects of delayed cord clamping on childhood development at age 4. Delayed clamping (n=141) was defined as occurring 3 or more minutes after delivery, and early clamping (n=122) was defined as occurring 10 seconds or fewer after delivery.
The researchers evaluated child behavior and development using parents’ responses on the Ages and Stages Questionnaire, Third Edition (ASQ), which is used to assess communication, motor skills, and other measures; and the Strengths and Difficulties Questionnaire, which is used to score children’s emotional difficulties, hyperactivity, and other difficulties.
A blinded psychologist also assessed children’s scores on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III), which is used to assess IQ and similar measures, and the Movement Assessment Battery for Children (Movement ABC), which is used to assess manual dexterity and similar measures.
The researchers found no significant differences between the delayed and early clamping groups with regard to results on the WPPSI-III or the Movement ABC.
However, delayed clamping was associated with a significant improvement over early clamping in ASQ personal-social scores (adjusted mean difference [AMD]=2.8, P=0.006), fine-motor scores (AMD=2.1, P=0.03), and the Strengths and Difficulties Questionnaire prosocial subscale (AMD=0.5, P=0.05).
When the researchers assessed the children according to sex, they found that significant improvements associated with delayed clamping were only present in males.
Males in the delayed clamping group had significantly higher mean scores in tasks involving fine-motor function, including the WPPSI-III processing-speed quotient (AMD=4.2, P=0.02), the Movement ABC bicycle-trail task (AMD=0.8, P=0.03), and fine-motor scores on the ASQ (AMD=4.7, P=0.01). These boys also had significantly higher personal-social scores on the ASQ (AMD=4.9, P=0.004).
The researchers concluded that, although delayed cord clamping and early clamping resulted in similar overall neurodevelopment and behavior among 4-year-old children, there were differences in this study. And this suggests there are some positive, and no harmful, long-term effects of delayed cord clamping.