ArticlePloS one2015
Ventilation onset prior to umbilical cord clamping (physiological-based cord clamping) improves systemic and cerebral oxygenation in preterm lambs.
Article in PloS one, 2015. 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 79 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
"Improves Physiological Based Cord Clamping (PBCC) the Systemic and Cerebral Oxygenation in Term Infants?"
Delayed Umbilical Cord Clamping in Elective Caesarean Section: What Are the Benefits
Delayed Cord Clamping With Oxygen In Extremely Low Gestation Infants
Physiological Umbilical Cord Clamping in Patients With Congenital Diaphragmatic Hernia. Clinical Trial
Who cites it
79 citing papers in PubMed, 2 syntheses or guidelines pooled it, 145 citations in OpenAlex.
- European Consensus Guidelines on the Management of Respiratory Distress Syndrome - 2019 Update.Neonatology · 2019Guideline
- Pooled it
- Rates and predictors of intraventricular hemorrhage in the ventfirst trial with comparison to a contemporaneous cohort.Journal of perinatology : official journal of the California Perinatal Association · 2026Trial
- Effect of intact cord resuscitation versus conventional cord clamping on clinical outcomes in very preterm neonates: a randomized controlled trial from Eastern India.European journal of pediatrics · 2026Trial
- Physiologic Transition During Delayed Cord Clamping With Assisted Ventilation in Preterm Infants: A Secondary Analysis of the VentFirst Trial.JAMA network open · 2025Trial
- Resuscitation With Placental Circulation Intact Compared With Cord Milking: A Randomized Clinical Trial.JAMA network open · 2024Trial
- Blood pressure and cerebral oxygenation with physiologically-based cord clamping: sub-study of the BabyDUCC trial.Pediatric research · 2024Trial
- Ventilatory Assistance Before Umbilical Cord Clamping in Extremely Preterm Infants: A Randomized Clinical Trial.JAMA network open · 2024Trial
- Extrauterine Placental Perfusion and Oxygenation in Infants With Very Low Birth Weight: A Randomized Clinical Trial.JAMA network open · 2023Trial
- A randomized controlled study of immediate versus delayed umbilical cord clamping in infants born by elective caesarean section.Italian journal of pediatrics · 2020Trial
- Neonatal Resuscitation with an Intact Cord: A Randomized Clinical Trial.The Journal of pediatrics · 2016Trial
- Early echocardiographic markers following deferred cord clamping with high or low oxygen in extremely low gestation infants (DOXIE-Echo).Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- A reduction in large animal research threatens the perinatal translation research pipeline.Pediatric research · 2026Review
- Impact of resuscitation with 100% oxygen during physiological-based cord clamping or immediate cord clamping on lung inflammation and injury.Pediatric research · 2026Article
- Physiological-Based Cord Clamping and Early Oxygenation in Newborns With Transposition of the Great Arteries: A Quality Improvement Study Protocol.CJC pediatric and congenital heart disease · 2026Article
- High-frequency oscillatory ventilation during physiological-based cord clamping attenuates inflammation in preterm lambs.Archives of disease in childhood. Fetal and neonatal edition · 2026Article
- Optimal Duration of Umbilical Cord Clamping with Ventilation in a Preterm Asphyxiated Ovine Model.Children (Basel, Switzerland) · 2025Article
- Article
- Significant interactions in infant operculum regions when exposed to a bilingual environment: a resting-state fNIRS study.Neurophotonics · 2025Article
- Non-ventilatory events substantially contribute to rise in pulmonary arterial blood flow with early or delayed cord clamping at birth in preterm lambs.The Journal of physiology · 2025Article
19 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundAs measurement of arterial oxygen saturation (SpO2) is common in the delivery room, target SpO2 ranges allow clinicians to titrate oxygen therapy for preterm infants in order to achieve saturation levels similar to those seen in normal term infants in the first minutes of life. However, the influence of the onset of ventilation and the timing of cord clamping on systemic and cerebral oxygenation is not known.
aimWe investigated whether the initiation of ventilation, prior to, or after umbilical cord clamping, altered systemic and cerebral oxygenation in preterm lambs.
methodsSystemic and cerebral blood-flows, pressures and peripheral SpO2 and regional cerebral tissue oxygenation (SctO2) were measured continuously in apnoeic preterm lambs (126±1 day gestation). Positive pressure ventilation was initiated either 1) prior to umbilical cord clamping, or 2) after umbilical cord clamping. Lambs were monitored intensively prior to intervention, and for 10 minutes following umbilical cord clamping.
resultsClamping the umbilical cord prior to ventilation resulted in a rapid decrease in SpO2 and SctO2, and an increase in arterial pressure, cerebral blood flow and cerebral oxygen extraction. Ventilation restored oxygenation and haemodynamics by 5-6 minutes. No such disturbances in peripheral or cerebral oxygenation and haemodynamics were observed when ventilation was initiated prior to cord clamping.
conclusionThe establishment of ventilation prior to umbilical cord clamping facilitated a smooth transition to systemic and cerebral oxygenation following birth. SpO2 nomograms may need to be re-evaluated to reflect physiological management of preterm infants in the delivery room.
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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.