Premature babies: waiting before cutting the umbilical cord reduces the risk of death – In the news

2023-12-18 10:16:52

December 18, 2023

According to two meta-analyses published in The Lancet, delaying umbilical cord clamping in premature babies would reduce the risk of death by at least a third.

The ideal time to cut the umbilical cord would depend on the circumstances of the birth. As it is now recommended to wait one to two minutes before clamping the umbilical cord of babies born at term, Australian scientists investigated whether this technique could benefit premature children.

« Worldwide, nearly 13 million babies are born prematurely each year and nearly a million die shortly after birth. », recalls Dr Anna Lene Seidler of the University of Sydney. With her teams, she therefore reviewed several dozen works carried out on the subject.

Between 30 and 180 seconds

Their first analysis focused on 21 trials comparing delayed clamping (between 30 and 180 seconds) with immediate clamping of the umbilical cord in more than 3,000 premature babies. In total, 6% of babies who received delayed clamping died before leaving the hospital compared to 8.2% whose cord was cut immediately. “ Delayed clamping would reduce the risk of death by a third », say the authors.

In the second analysis of 47 trials for more than 6,000 infants, delayed clamping was divided into three groups: “short delay” (15 to 45 seconds), “medium delay” (45 to 120 seconds) and “long delay” (120 seconds or more). As a result, waiting at least two minutes before clamping the cord reduces the risk of death in premature babies by two thirds.

« Until recently, it was common practice to clamp the umbilical cord immediately after the birth of premature babies so that they could be dried, wrapped and, if necessary, resuscitated easily », conclude the authors. Our study shows that there is no longer a need for immediate clamping and, on the contrary, currently available evidence suggests that delaying cord clamping for at least two minutes is likely the best cord management strategy to reduce cord clamping. risk of death. » So, waiting would allow blood to flow from the placenta to the baby while his lungs fill with air. This could potentially ease the transition to breathing and reduce the risk of iron deficiency in infants.

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