Universal delayed cord clamping in term infants is linked to hyperbilirubinemia risk

  • Obstet Gynecol

  • International Clinical Digest
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Takeaway

  • Delayed cord clamping in term infants is associated with increased risk for jaundice.

Why this matters

  • Universal delayed cord-clamping protocols for preterm neonates provide benefits, including reduced incidence of intraventricular hemorrhage, enterocolitis, sepsis, and mortality.
  • The association of benefits of delayed cord clamping in full-term infants is less clear.
  • The American College of Obstetricians and Gynecologists (ACOG) recommends delayed cord clamping for all neonates.

Key results

  • Mean peak neonatal transcutaneous bilirubin levels were higher in neonates with delayed cord clamping (10.0 vs 8.4 mg/dL; P<.01>
  • Diagnosis of jaundice was made more often after delayed cord clamping (27.2% vs 16.6%; P=.01).
  • No difference in mean peak serum bilirubin levels between groups (P=.17).
  • No difference in need for phototherapy between groups.  

Study design

  • Retrospective cohort study.
  • Term infants before (n=395) and after (n=399) implementation of a universal delayed cord-clamping protocol were compared.
  • Primary outcome was the difference in peak mean neonatal transcutaneous bilirubin levels.
  • Funding: None disclosed.

Limitations

  • Single academic center; results may not be generalizable.
  • Although jaundice was increased, the need for phototherapy was not; it is unclear how to interpret these results.

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