Effects of early and late clamping of umbilical cord on infant's haemoglobin level

Abstract

The literature on neonatal and placental blood volume and on the effect on the haemoglobin level of the neonate of early and late clamping of the umbilical cord is reviewed. Haematological investigations on a series of 133 apparently healthy pregnant white women and their infants are described. In 63 cases the umbilical cord was clamped immediately the infant was born, and in 70 cases the cord was clamped only after the cord had been stripped. The mean haemoglobin levels in the late-clamped infants between 13 and 24 hours and 72 and 96 hours of age were significantly higher statistically than the mean haemoglobin levels in the early-clamped infants. At 3 months of age the mean haemogloblin level in the early-clamped infants was 11.08 g./100 ml., and in the late-clamped infants 11.09 g./100 ml. Three months is considered to be the latest time at which it is practicably possible to assess the effect of such a factor. The advantages of late clamping of the umbilical cord may be of importance only in premature infants or in those infants born after traumatic deliveries. The objections to late clamping of the umbilical cord are discussed. Most workers do not believe that an increased incidence of jaundice occurs. The theoretical implications of extra blood in the infant’s circulation in the presence of anomalies of the cardiovascular system, intracranial haemorrhage, asphyxia with circulatory failure, and maternal-foetal blood incompatibility are mentioned. © 1960, British Medical Journal Publishing Group. All rights reserved.