Latest research on cord clamping

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We will continously blog on our own and others results on cord clamping, as well as other news related to the subject, such as umbilical cord milking and resuscitation.

Latest posts from the blog

11 February 2017
In memory of Hans Rosling:

Curiosity. Commitment. Factfullness.
On three occasions, Hans tweeted about our research. Obviously, I was both surprised and proud that this occupied and certainly hard courted person had time to follow what we've done. Now he is deceased, lost to all of us, but especially of course for his family, friends and loved ones.
There are many who have shared their memory of Hans Rosling during the recent days, yet I cannot help but share my thoughts with you.
We are many who admire Hans and what he accomplished, from his many years of work as a doctor in Africa, his research and start-up of programs in global health and his work with Gapminder. His humanism. In all I think three words shines brightly:
Curiosity. Commitment. Factfullness.
Hans always seemed to be curious, to phenomena in the world around us, curious on people, to figure out how the earth can be better place to live. The altruistic commitment he radiated, the commitment to spread knowledge, to help people, the passion to reach out, not to gain personal benefit, but for everyone's best. And then the word that Hans is said to have coined, and he was writing a book about: factfulness. To see past our own beliefs and prejudices. The ability to see the reality that is in front of us and to base our arguments on facts and not something else.
This last has never been so important as today, when many of us so easily begin to listen to the populists and the prophets of doom, the Trumps and right extremes.
Others have written that Hans Rosling's voice was more important now than ever before. I guess what we really should say is that everyone's vote is more important than in a long time.
When similar winds as from before World War II blows cold all around us, then it is time to join Hans Rosling disciples to become apostles: Start with a good dose of humanism and add thereto Curiosity. Commitment. And perhaps above all Factfulness.
Thanks for all Hans. I will try my best to honor your memory.

Memorial fund in honor of Hans Rosling
​​​​​​​https://unicef.se/egna-insamlingar/3866-memorial-fund-in-honor-of-hans-rosling​​​​​​​

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22 January 2017
3 reasons for clamping the umbilical cord after 3 minutes
14 January 2017
30 seconds might be enough when delaying cord clamping at cesarean sections

Research

Latest posts on NEW research

Two of the persons involved in the development of Lifestart trolley (http://www.inditherm.com/medical/neonatal-resuscitation-lifestart/) has published a review in Maternal Health, Neonatology and Perinatology.
"Abstract: The rationale for keeping the mother and her newborn together even when neonatal resuscitation is required is presented. The development of a customised mobile resuscitation trolley is detailed explaining how the resuscitation team can be provided with all the facilities of a standard resuscitation trolley to resuscitate the neonate at the mother’s side with an intact cord. Alternative low tech solutions which may be appropriate in low resource setting and with a low risk population are also described."

http://mhnpjournal.biomedcentral.com/articles/10.1186/s40748-016-0034-9

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9 July 2015
Delayed clamping vs. milking in preterm infants
12 June 2015
Review on delivery room management of newly born infants
23 May 2015
Cardiac changes during delayed cord clamping
3 May 2015
Delayed cord clamping with and without cord stripping: a prospective randomized trial of preterm neo
12 April 2015
Delayed cord clamping in South African neonates with expected low birthweight

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Google Alert - cord clamping

  • Benefits of delayed cord clamping

    11 December 2019 04:45
    Benefits Of Delayed Cord Clamping. Several research and studies on this condition have been proven that cord clamping also has positive effects for ...
  • Holistic Heritage Homebirth

    11 December 2019 02:13
    Another reason to delay cord clamping!!... ... Science Update: Delayed cord clamping may benefit infant brain development, NIH-funded study finds.
  • Cord away

    11 December 2019 01:11
    What Is Delayed Cord Clamping? All about the battery. 9 DO NOT run the vacuum cleaner over the power cord, close a door on the ...
  • Flax umbilical cord

    11 December 2019 01:07
    Available in - Jade, Aotea, Rhodonite, A muka Pito Tie can be used to tie off the umbilical cord instead of using a plastic cord clamp. " In 2010 he ...
  • The Impact of Early Versus Delayed Umbilical Cord Clamping in Preeclamptic Pregnant Patients ...

    10 December 2019 15:22
    To compare the different maternal and neonatal impacts of early versus delayed umbilical cord clamping among pregnant preeclamptic patients ...

pubmed: cord clamping newbor...

  • Association of Umbilical Cord Milking vs Delayed Umbilical Cord Clamping With Death or Severe Intraventricular Hemorrhage Among Preterm Infants.


    Related Articles
    Association of Umbilical Cord Milking vs Delayed Umbilical Cord Clamping With Death or Severe Intraventricular Hemorrhage Among Preterm Infants.
    JAMA. 2019 11 19;322(19):1877-1886
    Authors: Katheria A, Reister F, Essers J, Mendler M, Hummler H, Subramaniam A, Carlo W, Tita A, Truong G, Davis-Nelson S, Schmölzer G, Chari R, Kaempf J, Tomlinson M, Yanowitz T, Beck S, Simhan H, Dempsey E, O'Donoghue K, Bhat S, Hoffman M, Faksh A, Arnell K, Rich W, Finer N, Vaucher Y, Khanna P, Meyers M, Varner M, Allman P, Szychowski J, Cutter G
    Abstract
    Importance: Umbilical cord milking as an alternative to delayed umbilical cord clamping may provide equivalent benefits to preterm infants, but without delaying resuscitation.
    Objective: To determine whether the rates of death or severe intraventricular hemorrhage differ among preterm infants receiving placental transfusion with umbilical cord milking vs delayed umbilical cord clamping.
    Design, Setting, and Participants: Noninferiority randomized clinical trial of preterm infants (born at 23-31 weeks' gestation) from 9 university and private medical centers in 4 countries were recruited and enrolled between June 2017 and September 2018. Planned enrollment was 750 per group. However, a safety signal comprising an imbalance in the number of severe intraventricular hemorrhage events by study group was observed at the first interim analysis; enrollment was stopped based on recommendations from the data and safety monitoring board. The planned noninferiority analysis could not be conducted and a post hoc comparison was performed instead. Final date of follow-up was December 2018.
    Interventions: Participants were randomized to umbilical cord milking (n = 236) or delayed umbilical cord clamping (n = 238).
    Main Outcomes and Measures: The primary outcome was a composite of death or severe intraventricular hemorrhage to determine noninferiority of umbilical cord milking with a 1% noninferiority margin.
    Results: Among 540 infants randomized, 474 (88%) were enrolled and completed the trial (mean gestational age of 28 weeks; 46% female). Twelve percent (29/236) of the umbilical cord milking group died or developed severe intraventricular hemorrhage compared with 8% (20/238) of the delayed umbilical cord clamping group (risk difference, 4% [95% CI, -2% to 9%]; P = .16). Although there was no statistically significant difference in death, severe intraventricular hemorrhage was statistically significantly higher in the umbilical cord milking group than in the delayed umbilical cord clamping group (8% [20/236] vs 3% [8/238], respectively; risk difference, 5% [95% CI, 1% to 9%]; P = .02). The test for interaction between gestational age strata and treatment group was significant for severe intraventricular hemorrhage only (P = .003); among infants born at 23 to 27 weeks' gestation, severe intraventricular hemorrhage was statistically significantly higher with umbilical cord milking than with delayed umbilical cord clamping (22% [20/93] vs 6% [5/89], respectively; risk difference, 16% [95% CI, 6% to 26%]; P = .002).
    Conclusions and Relevance: In this post hoc analysis of a prematurely terminated randomized clinical trial of umbilical cord milking vs delayed umbilical cord clamping among preterm infants born at less than 32 weeks' gestation, there was no statistically significant difference in the rate of a composite outcome of death or severe intraventricular hemorrhage, but there was a statistically significantly higher rate of severe intraventricular hemorrhage in the umbilical cord milking group. The early study termination and resulting post hoc nature of the analyses preclude definitive conclusions.
    Trial Registration: ClinicalTrials.gov Identifier: NCT03019367.
    PMID: 31742630 [PubMed - indexed for MEDLINE]
  • Effect of Delayed vs Immediate Umbilical Cord Clamping on Maternal Blood Loss in Term Cesarean Delivery: A Randomized Clinical Trial.


    Related Articles
    Effect of Delayed vs Immediate Umbilical Cord Clamping on Maternal Blood Loss in Term Cesarean Delivery: A Randomized Clinical Trial.
    JAMA. 2019 11 19;322(19):1869-1876
    Authors: Purisch SE, Ananth CV, Arditi B, Mauney L, Ajemian B, Heiderich A, Leone T, Gyamfi-Bannerman C
    Abstract
    Importance: The American College of Obstetricians and Gynecologists recommends a delay in umbilical cord clamping in term neonates for at least 30 to 60 seconds after birth. Most literature supporting this practice is from low-risk vaginal deliveries. There are no published data specific to cesarean delivery.
    Objective: To compare maternal blood loss with immediate cord clamping vs delayed cord clamping in scheduled cesarean deliveries at term (≥37 weeks).
    Design, Setting, and Participants: Randomized clinical trial performed at 2 hospitals within a tertiary academic medical center in New York City from October 2017 to February 2018 (follow-up completed March 15, 2018). A total of 113 women undergoing scheduled cesarean delivery of term singleton gestations were included.
    Interventions: In the immediate cord clamping group (n = 56), cord clamping was within 15 seconds after birth. In the delayed cord clamping group (n = 57), cord clamping was at 60 seconds after birth.
    Main Outcomes and Measures: The primary outcome was change in maternal hemoglobin level from preoperative to postoperative day 1, which was used as a proxy for maternal blood loss. Secondary outcomes included neonatal hemoglobin level at 24 to 72 hours of life.
    Results: All of the 113 women who were randomized (mean [SD] age, 32.6 [5.2] years) completed the trial. The mean preoperative hemoglobin level was 12.0 g/dL in the delayed and 11.6 g/dL in the immediate cord clamping group. The mean postoperative day 1 hemoglobin level was 10.1 g/dL in the delayed group and 9.8 g/dL in the immediate group. There was no significant difference in the primary outcome, with a mean hemoglobin change of -1.90 g/dL (95% CI, -2.14 to -1.66) and -1.78 g/dL (95% CI, -2.03 to -1.54) in the delayed and immediate cord clamping groups, respectively (mean difference, 0.12 g/dL [95% CI, -0.22 to 0.46]; P = .49). Of 19 prespecified secondary outcomes analyzed, 15 showed no significant difference. The mean neonatal hemoglobin level, available for 90 neonates (79.6%), was significantly higher with delayed (18.1 g/dL [95% CI, 17.4 to 18.8]) compared with immediate (16.4 g/dL [95% CI, 15.9 to 17.0]) cord clamping (mean difference, 1.67 g/dL [95% CI, 0.75 to 2.59]; P < .001). There was 1 unplanned hysterectomy in each group.
    Conclusions and Relevance: Among women undergoing scheduled cesarean delivery of term singleton pregnancies, delayed umbilical cord clamping, compared with immediate cord clamping, resulted in no significant difference in the change in maternal hemoglobin level at postoperative day 1.
    Trial Registration: ClinicalTrials.gov Identifier: NCT03150641.
    PMID: 31742629 [PubMed - indexed for MEDLINE]
  • Implementation of Delayed Cord Clamping in Vigorous Preterm Neonates.


    Related Articles
    Implementation of Delayed Cord Clamping in Vigorous Preterm Neonates.
    J Obstet Gynecol Neonatal Nurs. 2018 11;47(6):803-811
    Authors: Aliyev G, Gallo AM
    Abstract
    OBJECTIVE: To adopt evidence-based recommendations to delay cord clamping in vigorous preterm neonates.
    DESIGN: Evidence-based practice change project with quantitative data.
    SETTING/LOCAL PROBLEM: Delayed cord clamping (DCC) was not a usual practice at the hospital where this project took place, despite research findings that show benefits of DCC for preterm neonates.
    PARTICIPANTS: Vigorous neonates born before 37 weeks completed gestation.
    INTERVENTION/MEASUREMENT: An interprofessional obstetric team of obstetricians and registered nurses implemented DCC for up to 1 minute for vigorous preterm neonates.
    RESULTS: We found that Apgar scores at 1 minute (mean [M] = 8.35, standard deviation [SD] = .551, n = 31) were statistically significantly higher with DCC than at 1 minute with immediate cord clamping (M = 7.16, SD = 1.834, n = 19) at t (20.008) = 1.197, p = .012. The Apgar scores at 5 minutes (M = 9.00, SD = 0.258, n = 31) were statistically significantly higher with DCC than at 5 minutes with immediate cord clamping (M = 8.58, SD = .838, n = 19) at t (20.116) = 2.130, p = 0.046.
    CONCLUSION: Delayed cord clamping was adopted as a usual clinical practice, and implementation of this practice in vigorous preterm neonates increased their Apgar scores. The obstetric team's awareness, experience, and professional perspectives about DCC improved.
    PMID: 30292775 [PubMed - indexed for MEDLINE]

ALtimetric score

Measure of how our paper in JAMA Pediatrics 2017 on anemia is spread by media

Measure of how our paper in JAMA Pediatrics 2015 on neurodevelopment is spread by media

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