ArticleObstetrics and gynecology2017
Evaluation of Introduction of a Delayed Cord Clamping Protocol for Premature Neonates in a High-Volume Maternity Center.
Article in Obstetrics and gynecology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis 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.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Impact of Implementation Tools for Spontaneous Preterm Birth Guidelines: A Systematic Review and Meta-Analysis.BJOG : an international journal of obstetrics and gynaecology · 2025Pooled it
- Cesarean delivery on maternal request and common child health outcomes: A prospective cohort study in China.Journal of global health · 2022Trial
- Integrated review of the knowledge, attitudes, and practices of maternity health care professionals concerning umbilical cord clamping.Birth (Berkeley, Calif.) · 2022Review
- Quality improvement for neonatal resuscitation and delivery room care.Seminars in perinatology · 2022Review
- Neonatal transitional support with intact umbilical cord in assisted vaginal deliveries: a quality-improvement cohort study.BMC pregnancy and childbirth · 2020Article
- Early versus delayed umbilical cord clamping on maternal and neonatal outcomes.Archives of gynecology and obstetrics · 2019Review
- Optimizing Cord Clamping in Preterm Infants: One Strategy Does Not Fit All.Frontiers in pediatrics · 2019Article
- Implementing delayed umbilical cord clamping in Nepal-Delivery care staff's perceptions and attitudes towards changes in practice.PloS one · 2019Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo evaluate adherence to a delayed cord clamping protocol for preterm births in the first 2 years after its introduction, perform a quality improvement assessment, and determine neonatal outcomes associated with protocol implementation and adherence.
methodsThis is a retrospective cohort study of women delivering singleton neonates at 23-32 weeks of gestation in the 2 years before (preprotocol) and 2 years after (postprotocol) introduction of a 30-second delayed cord clamping protocol at a large-volume academic center. This policy was communicated to obstetric and pediatric health care providers and nurses and reinforced with intermittent educational reviews. Barriers to receiving delayed cord clamping were assessed using χ tests and multivariable logistic regression. Neonatal outcomes then were compared between all neonates in the preprotocol period and all neonates in the postprotocol period and between all neonates in the preprotocol period and neonates receiving delayed cord clamping in the postprotocol period using multivariable linear and logistic regression analyses.
resultsOf the 427 eligible neonates, 187 were born postprotocol. Of these, 53.5% (n=100) neonates received delayed cord clamping according to the protocol. The rate of delayed cord clamping preprotocol was 0%. Protocol uptake and frequency of delayed cord clamping increased over the 2 years after its introduction. In the postprotocol period, cesarean delivery was the only factor independently associated with failing to receive delayed cord clamping (adjusted odds ratio [OR] 0.49, 95% confidence interval [CI] 0.25-0.96). In comparison with the preprotocol period, those who received delayed cord clamping in the postprotocol period had significantly higher birth hematocrit (β=2.46, P=.007) and fewer blood transfusions in the first week of life (adjusted OR 0.49, 95% CI 0.25-0.96).
conclusionAfter introduction of an institutional delayed cord clamping protocol followed by continued health care provider education and quality feedback, the frequency of delayed cord clamping progressively increased. Compared with historical controls, performing delayed cord clamping in eligible preterm neonates was associated with improved neonatal hematologic indices, demonstrating the effectiveness of delayed cord clamping in a large-volume maternity unit.
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