ArticleThe Lancet regional health. Europe2025
Physiological versus time based cord clamping in very preterm infants (ABC3): a parallel-group, multicentre, randomised, controlled superiority trial.
Article in The Lancet regional health. Europe, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03808051 (Physiological-based Cord Clamping in Very Preterm Infants), which is not on this map. Cited by 27 papers, 2 of them syntheses that pooled 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.
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.
Physiological-based Cord Clamping in Very Preterm Infants: a Multicentre Randomised Controlled Trial.
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Singapore Neonatal Resuscitation Guidelines 2026.Singapore medical journal · 2026Guideline
- European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2025.Neonatology · 2026Guideline
- 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
- Physiologic Transition During Delayed Cord Clamping With Assisted Ventilation in Preterm Infants: A Secondary Analysis of the VentFirst Trial.JAMA network open · 2025Trial
- Deferred Cord Clamping With High Oxygen in Extremely Preterm Infants: A Randomized Clinical Trial.JAMA pediatrics · 2025Trial
- Neurodevelopmental Outcomes of Very Low Birth Weight Infants Following Extrauterine Placental Perfusion: A Follow-Up Study.Acta paediatrica (Oslo, Norway : 1992) · 2025Trial
- The Effect of Antenatal Paracetamol on Breathing Effort of Premature Infants at Birth: A Feasibility Trial.Children (Basel, Switzerland) · 2026Article
- Neonatal Deterioration During Physiologic Cord Clamping in the Setting of Acute Maternal Hypotension.Indian journal of pediatrics · 2026Article
- Blood loss due to diagnostic testing in extremely preterm infants in 22 European countries: a prospective observational study.EClinicalMedicine · 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
- Oxygen during deferred cord clamping: too much of a good thing?Pediatric research · 2026Article
- Impact of resuscitation with 100% oxygen during physiological-based cord clamping or immediate cord clamping on lung inflammation and injury.Pediatric research · 2026Article
- 2025 American and European Guidelines on Neonatal Resuscitation: Concordance and Differences.Neonatology · 2026Review
- [Interpretation of the "European consensus guidelines on the management of respiratory distress syndrome: 2025"].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2026Article
- How consistent are recent neonatal resuscitation guidelines?Resuscitation plus · 2026Review
- EBNEO Commentary: Does High Oxygen Intact Cord Ventilation Improve Early Oxygenation in Preterm Infants?Acta paediatrica (Oslo, Norway : 1992) · 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
- Hospital-acquired infections in preterm infants with gestational age <32 weeks: a retrospective study of clinical characteristics, pathogen distribution, and associated factors.Frontiers in pediatrics · 2026Article
- Review
- Neonatal reference intervals for salivary steroids: focus on prematurity, stressful events and perinatal betamethasone.Frontiers in pediatrics · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
27 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Physiological-based cord clamping (PBCC) in preterm infants is beneficial for cardiovascular transition at birth and may optimize placental transfusion. Whether PBCC can improve clinical outcomes is unknown. The aim of the Aeration, Breathing, Clamping (ABC3) trial was to test whether PBCC results in improved intact survival in very preterm infants. Methods: The ABC3 trial was a parallel-group, multicentre, randomised, controlled superiority clinical trial conducted in all Dutch tertiary referral centers for perinatal care involving infants born before 30 weeks of gestation. Infants were randomised to either PBCC or time-based delayed cord clamping (TBCC), stratified by gestational age and treatment center. Infants receiving PBCC were stabilised with umbilical cord intact, which was clamped after reaching cardiorespiratory stability (heart rate >100 bpm and SpO2 >85% while supplemental oxygen <40%). In TBCC the cord was clamped after 30-60 s. The primary outcome was survival without major cerebral injury and/or necrotizing enterocolitis. The primary and key secondary analyses were done in both the intention-to-treat and per-protocol populations. The trial was registered with ClinicalTrials.gov (NCT03808051). Findings: From January 25, 2019, through October 2, 2022, 669 infants were randomised (median gestational age 27 Interpretation: PBCC in very preterm infants did not increase survival without major cerebral injury or necrotizing enterocolitis compared to TBCC in the entire cohort. A possible beneficial effect in male infants requires confirmation from other trials. PBCC was safe to perform and parents reported more contentment and less anxiety. Funding: The Netherlands Organization for Health Research and Development.
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