Does delayed umbilical cord cutting improve the survival rate of preterm infants?

Image courtesy of Pixabay

撰文 | 杰丝·格林斯潘（Jess Greenspan）

Translation | Dong Zi Chenxi

In the face of premature birth, doctors usually cut the umbilical cord and then carry the newborn away for immediate medical intervention. But a new meta-analysis suggests that doctors shouldn't cut the umbilical cord so quickly, because the umbilical cord is delivering oxygen and antibody-rich blood to newborns.

To compare the treatment of the umbilical cord in the context of preterm birth, researchers collected raw data from dozens of randomized controlled trials involving nearly 10,000 preterm infants in multiple countries. This work was published in The Lancet (

The Lancet）上的研究表明，

When doctors wait a certain amount of time before clamping and cutting the umbilical cord, the risk of death in premature babies decreases

Globally, nearly 1 million premature babies die each year.

In one comparison study, researchers found that newborns had the highest survival rates when doctors waited at least two minutes before tying the umbilical cord — longer than the vast majority of current public health organizations recommend. "There's strong evidence that the longer the [wait], the better," said Jessica Illuzzi, an obstetric interventionist at Yale School of Medicine in the United States. ”

It wasn't until the 20th century, when the mode of delivery was transferred from the home to the hospital, that the practice of immediate umbilical cord ligation became common. However, since around 2011, studies have found that delaying umbilical cord ligation can increase total blood volume, red blood cell count, and iron stores in newborns, and can make it easier for babies to adapt to spontaneous breathing. Nowadays, many doctors choose to delay cord ligation.

Still, obstetricians are often hesitant to delay cord ligation in premature babies, says Anna Lene Seidler, a biostatistician at the University of Sydney in Italy (lead author of both studies), because premature babies are often born with significant health problems, such as sometimes not being able to breathe properly or not moving. But Seidler noted that health care providers can perform many medical procedures while the umbilical cord is intact, including maintaining a newborn's body temperature and stimulating the newborn to breathe on its own.

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