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Umbilical cord clamping in the early phases of the COVID-19 era - A systematic review and meta-analysis of reported practice and recommendations in guidelines

Berg, Johan LU orcid ; Thies-Lagergren, Li LU orcid ; Svedenkrans, Jenny LU ; Samkutty, Jeremiah ; Larsson, Sara Marie LU ; Mercer, Judith S ; Rabe, Heike ; Andersson, Ola LU orcid and Zaigham, Mehreen LU orcid (2023) In International Journal of Infectious Diseases 137. p.63-70
Abstract

OBJECTIVES: In the beginning of the COVID-19 pandemic, delayed umbilical cord clamping (CC) at birth may have been commonly discouraged despite a lack of convincing evidence of mother-to-neonate SARS-CoV-2 transmission. We aimed to systematically review guidelines, reports of practice and to analyze associations between timing of cord clamping and mother-to-neonate SARS-CoV-2 transmission during the early phases of the pandemic.

METHODS: Major databases were searched December 1, 2019 to July 20, 2021.

INCLUSION: studies and guidelines describing cord clamping practice in women with SARS-CoV-2 infection during pregnancy until two postnatal days, giving birth to live born neonates.

EXCLUSION: no extractable data. Two... (More)

OBJECTIVES: In the beginning of the COVID-19 pandemic, delayed umbilical cord clamping (CC) at birth may have been commonly discouraged despite a lack of convincing evidence of mother-to-neonate SARS-CoV-2 transmission. We aimed to systematically review guidelines, reports of practice and to analyze associations between timing of cord clamping and mother-to-neonate SARS-CoV-2 transmission during the early phases of the pandemic.

METHODS: Major databases were searched December 1, 2019 to July 20, 2021.

INCLUSION: studies and guidelines describing cord clamping practice in women with SARS-CoV-2 infection during pregnancy until two postnatal days, giving birth to live born neonates.

EXCLUSION: no extractable data. Two reviewers independently screened studies for eligibility and assessed study quality. Pooled prevalence rates were calculated.

RESULTS: Forty-eight studies (1476 neonates) and 40 guidelines were included. Delayed CC was recommended in 70.0% of the guidelines. Nevertheless, delayed CC was reported less often than early CC: 262/1476 (17.8%) vs. 511/1476 (34.6%). Neonatal SARS-CoV-2 positivity rates were similar following delayed (1.2%) and early CC (1.3%). Most SARS-CoV-2 transmissions (93.3%) occurred in utero.

CONCLUSION: Delayed CC did not seem to increase mother-to-neonate SARS-CoV-2 transmission. Due to its benefits, it should be encouraged even in births where the mother has a SARS-CoV-2 infection.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Journal of Infectious Diseases
volume
137
pages
63 - 70
publisher
Elsevier
external identifiers
  • pmid:37839504
  • scopus:85175161254
ISSN
1878-3511
DOI
10.1016/j.ijid.2023.10.010
project
The effects of pre-, peri- and postnatal factors on the infant’s health and neurodevelopment
language
English
LU publication?
yes
additional info
Copyright © 2023. Published by Elsevier Ltd.
id
c6a075bf-1a72-423e-9e56-da64a0f393db
date added to LUP
2023-10-16 16:51:55
date last changed
2025-10-19 05:52:29
@article{c6a075bf-1a72-423e-9e56-da64a0f393db,
  abstract     = {{<p>OBJECTIVES: In the beginning of the COVID-19 pandemic, delayed umbilical cord clamping (CC) at birth may have been commonly discouraged despite a lack of convincing evidence of mother-to-neonate SARS-CoV-2 transmission. We aimed to systematically review guidelines, reports of practice and to analyze associations between timing of cord clamping and mother-to-neonate SARS-CoV-2 transmission during the early phases of the pandemic.</p><p>METHODS: Major databases were searched December 1, 2019 to July 20, 2021.</p><p>INCLUSION: studies and guidelines describing cord clamping practice in women with SARS-CoV-2 infection during pregnancy until two postnatal days, giving birth to live born neonates.</p><p>EXCLUSION: no extractable data. Two reviewers independently screened studies for eligibility and assessed study quality. Pooled prevalence rates were calculated.</p><p>RESULTS: Forty-eight studies (1476 neonates) and 40 guidelines were included. Delayed CC was recommended in 70.0% of the guidelines. Nevertheless, delayed CC was reported less often than early CC: 262/1476 (17.8%) vs. 511/1476 (34.6%). Neonatal SARS-CoV-2 positivity rates were similar following delayed (1.2%) and early CC (1.3%). Most SARS-CoV-2 transmissions (93.3%) occurred in utero.</p><p>CONCLUSION: Delayed CC did not seem to increase mother-to-neonate SARS-CoV-2 transmission. Due to its benefits, it should be encouraged even in births where the mother has a SARS-CoV-2 infection.</p>}},
  author       = {{Berg, Johan and Thies-Lagergren, Li and Svedenkrans, Jenny and Samkutty, Jeremiah and Larsson, Sara Marie and Mercer, Judith S and Rabe, Heike and Andersson, Ola and Zaigham, Mehreen}},
  issn         = {{1878-3511}},
  language     = {{eng}},
  month        = {{10}},
  pages        = {{63--70}},
  publisher    = {{Elsevier}},
  series       = {{International Journal of Infectious Diseases}},
  title        = {{Umbilical cord clamping in the early phases of the COVID-19 era - A systematic review and meta-analysis of reported practice and recommendations in guidelines}},
  url          = {{http://dx.doi.org/10.1016/j.ijid.2023.10.010}},
  doi          = {{10.1016/j.ijid.2023.10.010}},
  volume       = {{137}},
  year         = {{2023}},
}