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Therapeutics
Early umbilical cord clamping increases the risk of neonatal anaemia and infant iron deficiency
  1. Andrew Weeks
  1. Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
  1. Correspondence to: Andrew Weeks
    Department of Women's and Children's Health, University of Liverpool, Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, UK; aweeks{at}liv.ac.uk

https://doi.org/10.1136/ebmed-2012-100557

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    Commentary on: Andersson O, Hellström-Westas L, Andersson D, et al. Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomised controlled trial. BMJ 2011;343:d7157.OpenUrlAbstract/FREE Full Text

    Context

    Early cord clamping (ECC) has been practiced intermittently for over 100 years. However, it did not enter standard care until it was included, for convenience, as part of the package of active management of the third stage of labour (AMTSL). Since the 1980s, when the total package (oxytocic, controlled cord traction and early cord clamping) was shown to be effective at preventing postpartum haemorrhage (PPH,1), AMTSL has been vigorously promoted as a way of preventing maternal deaths.

    It is only in the last decade that the AMSTL package has been unpacked and it is becoming clear that it is only the oxytocic drug that reduces PPH – the controlled cord traction2 and early cord clamping (ECC)3 appear to have no …

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    Footnotes

    • Competing interests AW is one of the inventors of the Bedside Assessment, Stabilisation and Initial Circulatory Support (BASICS) trolley. This small resuscitation trolley allows neonatal resuscitation with an intact cord. Although the trolley is being developed in partnership with a commercial company, it has agreed that any inventors' royalties are to be given to charity.