Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Neurobehavioral Outcomes at 10 Years of Age following Delayed Umbilical Cord Clamping : A Follow-Up Study after a Randomized Trial

Isacson, Manuela LU ; Hellström-Westas, Lena LU ; Domellöf, Magnus ; Dahlgren, Jovanna ; Roswall, Josefine and Andersson, Ola LU orcid (2025) In Neonatology p.1-9
Abstract

INTRODUCTION: The aim of this study was to explore long-term behavioral consequences of early versus delayed cord clamping (CC) in school-aged children. The hypothesis was that early CC would be associated with an increased risk of symptoms associated with attention deficit hyperactivity disorder (ADHD) due to the lower iron stores following early CC compared with delayed CC.

METHODS: Exploratory, long-term follow-up study of a randomized controlled trial in Sweden. Full-term, vaginally born, neonates to healthy mothers were originally included and randomized to either early (≤10 s) or delayed (≥180 s) CC. At 10 years of age, scores from the screening questionnaire Swanson, Nolan and Pelham Scale IV (SNAP-IV), that identifies... (More)

INTRODUCTION: The aim of this study was to explore long-term behavioral consequences of early versus delayed cord clamping (CC) in school-aged children. The hypothesis was that early CC would be associated with an increased risk of symptoms associated with attention deficit hyperactivity disorder (ADHD) due to the lower iron stores following early CC compared with delayed CC.

METHODS: Exploratory, long-term follow-up study of a randomized controlled trial in Sweden. Full-term, vaginally born, neonates to healthy mothers were originally included and randomized to either early (≤10 s) or delayed (≥180 s) CC. At 10 years of age, scores from the screening questionnaire Swanson, Nolan and Pelham Scale IV (SNAP-IV), that identifies symptoms suggestive of ADHD (but do not diagnose ADHD), were compared between groups of early and delayed CC.

RESULTS: We assessed 139/382 (36.4%) children, 64 early CC and 75 delayed CC. No significance in total score and subgroup scores of SNAP-IV was seen when comparing early and delayed CC. In the primary outcome, total scores, mean (standard deviation) of early CC was 14.64 (13.94) and for delayed CC 13.59 (13.41), p = 0.65.

CONCLUSION: Timing of umbilical CC and iron status were not associated with symptoms associated with ADHD in 10-year-old children. Studies with higher follow-up rates and in populations with high prevalence of iron deficiency are needed to verify or discard the findings. Understanding if delayed CC has long-lasting neurobehavioral or neurodevelopmental effects can help develop guidelines and program about neonatal care.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Neonatology
pages
1 - 9
publisher
Karger
external identifiers
  • pmid:40744000
ISSN
1661-7800
DOI
10.1159/000547383
language
English
LU publication?
yes
additional info
© 2025 The Author(s). Published by S. Karger AG, Basel.
id
01d4b505-780e-4cf3-8010-679119b35d4e
date added to LUP
2025-09-11 20:23:38
date last changed
2025-09-12 07:15:21
@article{01d4b505-780e-4cf3-8010-679119b35d4e,
  abstract     = {{<p>INTRODUCTION: The aim of this study was to explore long-term behavioral consequences of early versus delayed cord clamping (CC) in school-aged children. The hypothesis was that early CC would be associated with an increased risk of symptoms associated with attention deficit hyperactivity disorder (ADHD) due to the lower iron stores following early CC compared with delayed CC.</p><p>METHODS: Exploratory, long-term follow-up study of a randomized controlled trial in Sweden. Full-term, vaginally born, neonates to healthy mothers were originally included and randomized to either early (≤10 s) or delayed (≥180 s) CC. At 10 years of age, scores from the screening questionnaire Swanson, Nolan and Pelham Scale IV (SNAP-IV), that identifies symptoms suggestive of ADHD (but do not diagnose ADHD), were compared between groups of early and delayed CC.</p><p>RESULTS: We assessed 139/382 (36.4%) children, 64 early CC and 75 delayed CC. No significance in total score and subgroup scores of SNAP-IV was seen when comparing early and delayed CC. In the primary outcome, total scores, mean (standard deviation) of early CC was 14.64 (13.94) and for delayed CC 13.59 (13.41), p = 0.65.</p><p>CONCLUSION: Timing of umbilical CC and iron status were not associated with symptoms associated with ADHD in 10-year-old children. Studies with higher follow-up rates and in populations with high prevalence of iron deficiency are needed to verify or discard the findings. Understanding if delayed CC has long-lasting neurobehavioral or neurodevelopmental effects can help develop guidelines and program about neonatal care.</p>}},
  author       = {{Isacson, Manuela and Hellström-Westas, Lena and Domellöf, Magnus and Dahlgren, Jovanna and Roswall, Josefine and Andersson, Ola}},
  issn         = {{1661-7800}},
  language     = {{eng}},
  month        = {{07}},
  pages        = {{1--9}},
  publisher    = {{Karger}},
  series       = {{Neonatology}},
  title        = {{Neurobehavioral Outcomes at 10 Years of Age following Delayed Umbilical Cord Clamping : A Follow-Up Study after a Randomized Trial}},
  url          = {{http://dx.doi.org/10.1159/000547383}},
  doi          = {{10.1159/000547383}},
  year         = {{2025}},
}