Evidence map›Paper›PMID 15495045›Full record

SynthesisThe Cochrane database of systematic reviews2004

Early versus delayed umbilical cord clamping in preterm infants.

H Rabe, G Reynolds, J Diaz-Rossello

4 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 58 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01666847 nacompletednot on this mapstarted 2012, after this paper: background citation

Milking the Umbilical Cord for Extreme Preterm Infants

TypeinterventionalSponsorSt. Louis UniversityRan2012 to 2017Enrolled59ConditionsInfant, Extremely PrematureArmsMilking the umbilical cord before cord clamping
NCT02454101 nacompletednot on this mapstarted 2015, after this paper: background citation

Milking Versus Delayed Cord Clamping in Full Term Neonates Delivered by Elective Cesarean Section A Randomized Controlled Trial

TypeinterventionalSponsorAhmed Mohamed El Kotb Abdel FattahRan2015 to 2016Enrolled300ConditionsNeonatal AnemiaArmscord milking, delayed cord clamping
NCT04413097 naactive not recruitingnot on this mapstarted 2021, after this paper: background citation

Delayed Cord Clamping With Oxygen In Extremely Low Gestation Infants

TypeinterventionalSponsorSharp HealthCareRan2021 to 2026Enrolled140ConditionsIVH- Intraventricular Hemorrhage, Extreme Prematurity, Hypoxia Neonatal, HyperoxiaArmsDelayed Cord Clamping with Low Oxygen concentration, Delayed Cord Clamping with High Oxygen concentration
NCT04898868 nacompletednot on this mapstarted 2021, after this paper: background citation

Investigation on the Effects of Delayed Cord Clamping on Maternal and Neonatal Outcomes: Part I. Association Between Blood Volume, the Interval From Delivery to Cord Clamping, and Number of Umbilical Cord Milking

TypeinterventionalSponsorChang Gung Memorial HospitalRan2021 to 2021Enrolled80ConditionsPregnancy Related, Umbilical Cord Issue, Placental TransfusionArmscord blood spontaneous drainage, Umbilical cord miking
3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 10 syntheses or guidelines pooled it, 263 citations in OpenAlex.

  1. Pooled it
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  7. Active versus expectant management for women in the third stage of labour.The Cochrane database of systematic reviews · 2011
    Pooled it
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  11. Trial
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  14. [Influence of delayed cord clamping on preterm infants with a gestational age of <32 weeks].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2016
    Trial
  15. Timing of umbilical cord clamping among infants born at 22 through 27 weeks' gestation.Journal of perinatology : official journal of the California Perinatal Association · 2016
    Trial
  16. Comparison of three types of intervention to enhance placental redistribution in term newborns: randomized control trial.Journal of perinatology : official journal of the California Perinatal Association · 2015
    Trial
  17. Effects of delayed cord clamping in very-low-birth-weight infants.Journal of perinatology : official journal of the California Perinatal Association · 2011
    Trial
  18. Trial
  19. A pilot randomized controlled trial of controlled cord traction to reduce postpartum blood loss.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2009
    Trial
  20. The effect of early and late umbilical cord clamping on neonatal hematocrit.Journal of perinatology : official journal of the California Perinatal Association · 2008
    Trial
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 4 countries.

H RabeTrevor Mann Baby Unit, Brighton and Sussex University Hospitals, Royal Sussex Country Hospital, Eastern Road, Brighton, UK, BN2 5BE. heike.rabe@bsuh.nhs.uk
G Reynolds
J Diaz-Rossello
Canberra Hospital · AURoyal Sussex County Hospital · GBWorld Health Organization · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOptimal timing for clamping of the umbilical cord at birth is unclear. Early clamping allows for immediate resuscitation of the newborn. Delaying clamping may facilitate transfusion of blood between the placenta and the baby.

objectivesTo delineate the short- and long-term effects for infants born at less than 37 completed weeks' gestation, and their mothers, of early compared to delayed clamping of the umbilical cord at birth. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register (2 February 2004), the Cochrane Neonatal Group trials register (2 February 2004), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2004), PubMed (1966 to 2 February 2004) and EMBASE (1974 to 2 February 2004). SELECTION CRITERIA: Randomized controlled trials comparing early with delayed (30 seconds or more) clamping of the umbilical cord for infants born before 37 completed weeks' gestation. DATA COLLECTION AND ANALYSIS: Three reviewers assessed eligibility and trial quality. MAIN

resultsSeven studies (297 infants) were eligible for inclusion. The maximum delay in cord clamping was 120 seconds. Delayed cord clamping was associated with a higher hematocrit four hours after birth (four trials, 134 infants; weighted mean difference 5.31, 95% confidence interval (CI) 3.42 to 7.19), fewer transfusions for anaemia (three trials, 111 infants; relative risk (RR) 2.01, 95% CI 1.24 to 3.27) or low blood pressure (two trials, 58 infants; RR 2.58, 95% CI 1.17 to 5.67) and less intraventricular haemorrhage (five trials, 225 infants; RR 1.74, 95% CI 1.08 to 2.81) than early clamping. REVIEWERS'

conclusionsDelaying cord clamping by 30 to 120 seconds, rather than early clamping, seems to be associated with less need for transfusion and less intraventricular haemorrhage. There are no clear differences in other outcomes.

Indexed as

Infant, PrematureUmbilical CordBlood TransfusionCerebral HemorrhageConstrictionHematocritHumansInfant, NewbornRandomized Controlled Trials as TopicRespiration DisordersTime Factors

Identifiers

PMID15495045
OpenAlexW1606127703

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.