Why one minute matters for premature newborns

New research has found waiting 60 seconds before clamping a premature baby’s umbilical cord, rather than clamping immediately, could be the difference between life and death. 

The study, led by the University of Sydney, found premature babies whose umbilical cords were clamped immediately after birth had a lower survival rate than those whose cords were clamped after waiting just 60 seconds longer.

It involved reviewing outcomes from 13 trials and almost 3000 babies born before 37 weeks' gestation. It found evidence that delayed clamping reduced hospital mortality by a third.

“We estimate that for every thousand very preterm babies born more than ten weeks early, delayed clamping will save up to 100 additional lives compared with immediate clamping,” said the University of Sydney’s Associate Professor David Osborn, the review’s lead author and a neonatal specialist at Royal Prince Alfred Hospital.

“This means that, worldwide, using delayed clamping instead of immediate clamping can be expected to save between 11,000 and 100,000 additional lives every year.”

The review involved two international studies which were coordinated by the University of Sydney’s National Health and Medical Research Council Clinical Trials Centre.

It’s been approved for publishing in the American Journal of Obstetrics and Gynecology.


The review shows for the first time that simply clamping the cord 60 seconds after birth improves survival.
Prof William Tarnow-Mordi, University of Sydney

“It confirms international guidelines recommending delayed clamping in all preterm babies who do not need immediate resuscitation," said Prof. William Tarnow-Mordi, senior author.

Bupa Medical Officer and General Practitioner Dr Kate Haggar says the results are extremely promising.

“We already use delayed cord clamping for full term babies due to the associated benefits for infant health and nutrition. This study takes it a step further by looking at the potential benefits to very premature infants born at less than 30 weeks gestation.”

“Currently the data is looking at the short term outcomes for these infants, but longer term outcomes and follow up are apparently planned. This may include looking at the long-term growth and development in these infants into childhood.”

Belinda Hutchingson AM, Chancellor of the University of Sydney, has experienced the emotional rollercoaster of preterm birth first-hand, and says research into this is invaluable.

“This is a cause which is very important to me, with my own granddaughter born at 28 weeks. She is now a vibrant three year old but I know many others don’t have such a great outcome which is why research in this area is so vital.”

Dr Haggar says it’s important to remember that in the case of babies needing immediate resuscitation, delayed clamping isn’t necessarily the best option.

“While delayed cord clamping, after a minute or more, appears to have benefits at any gestation, if a baby is struggling to breath and get oxygen, then immediate clamping is still a critical part of the resuscitation process.”

For information, tools and inspiration to help guide you through your First Thousand Days, from conception until a child turns two, click here.

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