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How Delayed Cord Clamping Saves Newborn Lives

Mercer, Judith ; Saether, Elisabeth ; King, Tekoa ; Maul, Holger ; Kennedy, Holly Powell ; Erickson-Owens, Debra ; Andersson, Ola LU orcid and Rabe, Heike (2025) In Children 12(5).
Abstract

Interest in the subject of umbilical cord clamping is long-standing. New evidence reveals that placental transfusion, facilitated by delayed cord clamping (DCC), reduces death and need for blood transfusions for preterm infants without evidence of harm. Even a brief delay in clamping the cord shows improved survival and well-being, but waiting at least two minutes is even better. We propose that three major benefits from DCC contribute to reduced mortality of preterm infants: (1) benefits from the components of blood; (2) assistance from the continued circulation of blood; and (3) the essential mechanical interactions that result from the enhanced volume of blood. The enhanced blood volume generates mechanical forces within the... (More)

Interest in the subject of umbilical cord clamping is long-standing. New evidence reveals that placental transfusion, facilitated by delayed cord clamping (DCC), reduces death and need for blood transfusions for preterm infants without evidence of harm. Even a brief delay in clamping the cord shows improved survival and well-being, but waiting at least two minutes is even better. We propose that three major benefits from DCC contribute to reduced mortality of preterm infants: (1) benefits from the components of blood; (2) assistance from the continued circulation of blood; and (3) the essential mechanical interactions that result from the enhanced volume of blood. The enhanced blood volume generates mechanical forces within the microcirculation that support the newborn’s metabolic and cardiovascular stability and secure short- and long-term organ health. Several unique processes prime preterm and term newborns to receive the full placental transfusion, not to be misinterpreted as extra blood or over-transfusion. Disrupting cord circulation before the newborn’s lung capillary bed has been fully recruited and the lungs can replace the placenta as a respiratory, gas-exchanging organ may be harmful. Early cord clamping also denies the newborn a full quota of iron-rich red blood cells as well as valuable stem cells for regeneration, repair, and seeding of a strong immune system. We propose that delayed cord clamping and intact-cord stabilization have the potential to save lives by protecting many neonates from hypovolemia, inflammation, and ischemia.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
blood volume, cord clamping, hypovolemia, inflammation, ischemia, jaundice, mechanotransduction, neonatal transition, placental transfusion, progesterone, sustained cord circulation
in
Children
volume
12
issue
5
article number
585
publisher
MDPI AG
external identifiers
  • pmid:40426764
  • scopus:105006438889
ISSN
2227-9067
DOI
10.3390/children12050585
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 by the authors.
id
3e654cf1-c5ed-4f56-a85a-4d46f1147703
date added to LUP
2025-07-15 12:18:24
date last changed
2025-07-24 10:27:18
@article{3e654cf1-c5ed-4f56-a85a-4d46f1147703,
  abstract     = {{<p>Interest in the subject of umbilical cord clamping is long-standing. New evidence reveals that placental transfusion, facilitated by delayed cord clamping (DCC), reduces death and need for blood transfusions for preterm infants without evidence of harm. Even a brief delay in clamping the cord shows improved survival and well-being, but waiting at least two minutes is even better. We propose that three major benefits from DCC contribute to reduced mortality of preterm infants: (1) benefits from the components of blood; (2) assistance from the continued circulation of blood; and (3) the essential mechanical interactions that result from the enhanced volume of blood. The enhanced blood volume generates mechanical forces within the microcirculation that support the newborn’s metabolic and cardiovascular stability and secure short- and long-term organ health. Several unique processes prime preterm and term newborns to receive the full placental transfusion, not to be misinterpreted as extra blood or over-transfusion. Disrupting cord circulation before the newborn’s lung capillary bed has been fully recruited and the lungs can replace the placenta as a respiratory, gas-exchanging organ may be harmful. Early cord clamping also denies the newborn a full quota of iron-rich red blood cells as well as valuable stem cells for regeneration, repair, and seeding of a strong immune system. We propose that delayed cord clamping and intact-cord stabilization have the potential to save lives by protecting many neonates from hypovolemia, inflammation, and ischemia.</p>}},
  author       = {{Mercer, Judith and Saether, Elisabeth and King, Tekoa and Maul, Holger and Kennedy, Holly Powell and Erickson-Owens, Debra and Andersson, Ola and Rabe, Heike}},
  issn         = {{2227-9067}},
  keywords     = {{blood volume; cord clamping; hypovolemia; inflammation; ischemia; jaundice; mechanotransduction; neonatal transition; placental transfusion; progesterone; sustained cord circulation}},
  language     = {{eng}},
  number       = {{5}},
  publisher    = {{MDPI AG}},
  series       = {{Children}},
  title        = {{How Delayed Cord Clamping Saves Newborn Lives}},
  url          = {{http://dx.doi.org/10.3390/children12050585}},
  doi          = {{10.3390/children12050585}},
  volume       = {{12}},
  year         = {{2025}},
}