Evidence map›Paper›PMID 22089242›Full record

Trial reportBMJ (Clinical research ed.)2011

Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomised controlled trial.

Ola Andersson, Lena Hellström-Westas, Dan Andersson, Magnus Domellöf

4 registry-linked trialsOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2011. 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 100 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
100citing papers in PubMed, 5 pooled it
20.7field-weighted citation impact, top 1% of its field
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.

NCT01245296 nacompletednot on this map

Early Versus Delayed Cord Clamping at Term: Outcomes in Swedish Infants

TypeinterventionalSponsorUppsala UniversityRan2008 to 2010Enrolled392ConditionsIron Deficiency, Neonatal HyperbilirubinemiaArmsTiming of clamping the umbilical cord
NCT01581489 completednot on this mapstarted 2012, after this paper: background citation

Early Versus Delayed Cord Clamping at Term: Neurodevelopmental Outcomes in Swedish Infants at 4 Years of Age

TypeobservationalSponsorUppsala UniversityRan2012 to 2013Enrolled263ConditionsDevelopmental Delay, Iron DeficiencyArmsTime to clamping of the umbilical cord after delivery
NCT02222805 nacompletednot on this mapstarted 2014, after this paper: background citation

Effect of Timing of Umbilical Cord Clamping on Anaemia at 8 and 12 Months and Later Neurodevelopment in Late Pre-term and Term Infants; a Facility-based Randomized-controlled Trial in Nepal

TypeinterventionalSponsorUppsala UniversityRan2014 to 2015Enrolled540ConditionsAnemia, Iron Deficiency, Neonatal JaundiceArmsEarly (≤30 seconds) cord clamping, Delayed (≤180 seconds) cord clamping
NCT04632264 nacompletednot on this mapstarted 2020, after this paper: background citation

Optimal Timing of Postpartum Oxytocin Administration in the Era of Delayed Cord Clamping - PROCEEDING (PostpaRtum OxytoCin Era dElayed corD clampING) Study

TypeinterventionalSponsorColumbia UniversityRan2020 to 2021Enrolled104ConditionsPostpartum HemorrhageArmsInitiation of standard postpartum oxytocin immediately following fetal shoulder delivery, Initiation of standard postpartum oxytocin immediately following placenta delivery, Saline Placebo
3 · Its place in the literature

Who cites it

100 citing papers in PubMed, 5 syntheses or guidelines pooled it, 382 citations in OpenAlex.

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40 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Ola AnderssonDepartment of Paediatrics, Hospital of Halland, Halmstad, SE-301 85 Halmstad, Sweden. ola.k.andersson@regionhalland.se
Lena Hellström-Westas
Dan Andersson
Magnus Domellöf
Hallands sjukhus Halmstad · SEUmeå University · SEUppsala University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the effects of delayed umbilical cord clamping, compared with early clamping, on infant iron status at 4 months of age in a European setting.

designRandomised controlled trial.

settingSwedish county hospital.

participants400 full term infants born after a low risk pregnancy.

interventionInfants were randomised to delayed umbilical cord clamping (≥ 180 seconds after delivery) or early clamping (≤ 10 seconds after delivery).

main outcome measuresHaemoglobin and iron status at 4 months of age with the power estimate based on serum ferritin levels. Secondary outcomes included neonatal anaemia, early respiratory symptoms, polycythaemia, and need for phototherapy.

resultsAt 4 months of age, infants showed no significant differences in haemoglobin concentration between the groups, but infants subjected to delayed cord clamping had 45% (95% confidence interval 23% to 71%) higher mean ferritin concentration (117 μg/L v 81 μg/L, P < 0.001) and a lower prevalence of iron deficiency (1 (0.6%) v 10 (5.7%), P = 0.01, relative risk reduction 0.90; number needed to treat = 20 (17 to 67)). As for secondary outcomes, the delayed cord clamping group had lower prevalence of neonatal anaemia at 2 days of age (2 (1.2%) v 10 (6.3%), P = 0.02, relative risk reduction 0.80, number needed to treat 20 (15 to 111)). There were no significant differences between groups in postnatal respiratory symptoms, polycythaemia, or hyperbilirubinaemia requiring phototherapy.

conclusionsDelayed cord clamping, compared with early clamping, resulted in improved iron status and reduced prevalence of iron deficiency at 4 months of age, and reduced prevalence of neonatal anaemia, without demonstrable adverse effects. As iron deficiency in infants even without anaemia has been associated with impaired development, delayed cord clamping seems to benefit full term infants even in regions with a relatively low prevalence of iron deficiency anaemia. Trial registration Clinical Trials NCT01245296.

Indexed as

Umbilical CordAdultAnemia, Iron-DeficiencyAnemia, NeonatalConstrictionDelivery, ObstetricErythrocyte IndicesFemaleFerritinsHumansInfant, NewbornMalePhototherapyPolycythemiaPregnancyTime FactorsFerritins

Identifiers

PMID22089242
PMCPMC3217058
OpenAlexW2102545214

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.