Alternative umbilical cord management strategies (delayed clamping and milking) may not have an effect on
Survival without neurodisability (authors note that there are limited studies with this finding as an endpoint)
Anemia in early infancy
Maternal postpartum hemorrhage
No differences were found in major neonatal morbidities in studies comparing methods for optimizing placental transfusion
DCC vs cut-cord milking (3 studies)
Longer delays in clamping (7 studies)
Physiologic parameters (3 studies)
Strategies that promote increased placental transfusion may be associated with greater phototherapy use
Evidence for all outcomes was low or very low certainty
Compared to ECC, both DCC and cord milking increases hemoglobin and hematocrit after birth in infants ≥34 weeks’ gestational age
Data consistent with Cochrane review
Further RCTs are necessary to assess longer term benefits
The authors state
Compared to ECC, DCC (at ≥30 seconds) and cord milking led to increased hemoglobin and hematocrit immediately after birth in infants ≥34 weeks’ gestational age
The effects of later clamping or use of cord milking in term and late preterm infants on survival without neurodisability, anemia in early infancy, or maternal PPH (and most other outcomes reported) are uncertain
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