Delayed Umbilical Cord Clamping is Not Associated with Acute Kidney Injury in Preemies

Delayed cord clamping (DCC) is the prolongation of the duration between the delivery of a child and the clamping of his/her umbilical cord. DDC lets enormous blood flow from the placenta to the newborn and helps increase the baby’s blood volume up to a third and therefore there’s also an increase in the newborn baby’s iron storage that is essential for healthy brain development.

DDC is usually done for preemies believing that their blood volume and iron content improves. Since iron deficiency during birth can cause cognitive impairment and other neurodevelopmental disorders, CCD has many benefits. However, scientists have also been debating about its drawbacks such as the risk of hyperbilirubinemia (excess bilirubin in the blood), polycythemia (elevated levels of RBC in the blood), respiratory distress or other problems in the newborns.

A recent study conducted by Harer MW et al sought to find out if DDC is linked with a reduced rate of neonatal acute kidney injury. The study involved 278 low weight preemies found that DDC was not associated with any reduction in the rates of AKI. However, their findings also suggested that DDC was not harmful to their kidneys. This emphasizes the fact that DDC is safe even in very low birth weight infants. Since acute kidney injury is linked to mortality rates among very low birth infants, this study clarifies that DDC does not cause AKI and reiterates the safety of DDC.

Several other studies have also confirmed the safety of DCC and encourage the practice. More mothers than ever have been inquiring about DDC and the World Health Organization (WHO) also recommends that the umbilical cord should not be clamped sooner than necessary. The optimal delay in umbilical cord clamping suggested by the WHO is about 1-3 minutes after birth. And the midwives opine that it is necessary to wait until the cord stops pumping.

Also, studies have suggested that immediate cord clamping does not need to be done unless the baby is suffocated or needs immediate resuscitation. The American Congress of Obstetricians and Gynecologists (ACOG) have also endorsed DCC in preterm infants.