Delayed cutting of umbilical cord may reduce complications

Waiting just an extra half-minute before cutting a premature infant's umbilical cord may help reduce the baby's risk of complications.

"A slight delay in cord clamping for preterm infants is beneficial with regard to better blood pressure after birth, less need of blood transfusion in the first weeks of life and less incidence of severe intraventricular hemorrhage [bleeding in the brain]," Dr. Heike Rabe, a consultant neonatologist at Brighton and Sussex University Hospitals in Great Britain, told HealthDay .

That conclusion stems from a review of seven studies, which included almost 300 premature infants, to try to assess the optimum time to clamp an umbilical cord. The review, conducted by Rabe and his colleagues, was published in the Cochrane Collaboration .

Infants are premature when they are delivered before 37 weeks' gestation. Almost 12 percent of American babies are born prematurely, according to the March of Dimes. Preterm labor can happen to any woman, and about half of all preterm deliveries occur in women who have no known risk factors for this complication of pregnancy, the organization reports.

However, premature infants have a higher risk of respiratory distress, feeding problems and bleeding in the brain.

The umbilical cord acts as a lifeline between mother and baby. During pregnancy, the baby receives oxygen through the umbilical cord. If cut too soon, the blood that is in the umbilical cord doesn't have time to return to the baby, which can result in low blood pressure and a low red blood cell count.

On the other hand, waiting too long to clamp the cord can cause additional problems, such as thickened blood, the researchers reported.

Rabe's review was not able to determine exactly what time is best to cut the cord, but they found that any time between 30 and 120 seconds was associated with fewer complications. In the researchers' opinion, 120 seconds was the maximum time that should elapse before the cord is clamped.

"This study seems to make good sense," Dr. James Pelegano, director of neonatology at Maimonides Medical Center and Lutheran Medical Center in New York City , told HealthDay . "We know that the amount of blood has a direct influence on blood pressure and that blood pressure has an influence on bleeding on the brain."

Still, he said, decisions must "be done on a case-by-case basis."

"It's better if you don't have to clamp quickly, but you don't always have that option," Pelegano explained. Sometimes, he said, premature infants are born in respiratory distress and must be treated for that complication immediately.