May 26, 2015
CHICAGO
-- May 26, 2015 -- Delayed clamping of the umbilical cord to help
prevent iron deficiency in infancy was associated with improved scores
in fine-motor and social skills in children at age 4, particularly in
boys, although it was not associated with any effect on overall IQ or
behaviour compared with children whose cords were clamped seconds after
delivery.
The findings are published online by JAMA Pediatrics.
Ola Andersson, MD, Uppsala University, Uppsala, Sweden, and colleagues conducted a follow-up of a randomised clinical trial at a Swedish hospital to assess the long-term effects of delayed cord clamping on neurodevelopment in children at age 4.
The researchers assessed 263 children (about 69% of the original study population) based on IQ tests, as well as development and behaviour using other assessments and questionnaires. Delayed cord clamping (141 children in follow-up) was ≥3 minutes after delivery and early cord clamping (122 children in follow-up) was ≤10 seconds after delivery.
The authors found no difference between the 2 groups for full-scale IQ. However, the proportion of children with an immature pencil grip was lower in the delayed cord clamping group and that group had higher scores in personal-social and fine-motor skill assessments.
There were no differences between the groups for girls in any of the assessments. However, boys who had delayed cord clamping had higher average scores in several tasks involving fine-motor function and personal-social domains.
“Delaying cord clamping for 3 minutes after delivery resulted in similar overall neurodevelopment and behaviour among 4-year-old children compared with early cord clamping,” the authors wrote. “However, we did find higher scores for parent-reported prosocial behaviour, as well as personal-social and fine-motor development at 4 years, particularly in boys.”
“The included children constitute a group of low-risk children born in a high-income country with a low prevalence of iron deficiency,” they added. “Still, differences between the groups were found, indicating that there are positive, and in no instance harmful, effects from delayed cord clamping. Future research should involve large groups to secure enough power to draw clear conclusions regarding development.”
In an accompanying editorial, Heike Rabe, MD, Brighton and Sussex Medical School and University Hospitals, Brighton, United Kingdom, wrote: “Until now, data on long-term follow-up of preterm and full-term infants who have been randomised to early versus delayed cord clamping have been limited. Awareness of the benefits for all newborns continues to increase as more studies are published. While many physicians have incorporated delayed cord clamping into practice, there remains a hesitation to implement delayed cord clamping, particularly with full-term infants. As evidence of the safety and benefits of delayed cord clamping are demonstrated, this hesitation should disappear. We applaud Andersson and colleagues for their persistence because their study closes the knowledge gap regarding the long-term safety of delayed cord clamping in healthy full-term newborns. Their important findings suggest that there is an absence of harm that lasts until 4 years of age.”
SOURCE: JAMA Pediatrics
The findings are published online by JAMA Pediatrics.
Ola Andersson, MD, Uppsala University, Uppsala, Sweden, and colleagues conducted a follow-up of a randomised clinical trial at a Swedish hospital to assess the long-term effects of delayed cord clamping on neurodevelopment in children at age 4.
The researchers assessed 263 children (about 69% of the original study population) based on IQ tests, as well as development and behaviour using other assessments and questionnaires. Delayed cord clamping (141 children in follow-up) was ≥3 minutes after delivery and early cord clamping (122 children in follow-up) was ≤10 seconds after delivery.
The authors found no difference between the 2 groups for full-scale IQ. However, the proportion of children with an immature pencil grip was lower in the delayed cord clamping group and that group had higher scores in personal-social and fine-motor skill assessments.
There were no differences between the groups for girls in any of the assessments. However, boys who had delayed cord clamping had higher average scores in several tasks involving fine-motor function and personal-social domains.
“Delaying cord clamping for 3 minutes after delivery resulted in similar overall neurodevelopment and behaviour among 4-year-old children compared with early cord clamping,” the authors wrote. “However, we did find higher scores for parent-reported prosocial behaviour, as well as personal-social and fine-motor development at 4 years, particularly in boys.”
“The included children constitute a group of low-risk children born in a high-income country with a low prevalence of iron deficiency,” they added. “Still, differences between the groups were found, indicating that there are positive, and in no instance harmful, effects from delayed cord clamping. Future research should involve large groups to secure enough power to draw clear conclusions regarding development.”
In an accompanying editorial, Heike Rabe, MD, Brighton and Sussex Medical School and University Hospitals, Brighton, United Kingdom, wrote: “Until now, data on long-term follow-up of preterm and full-term infants who have been randomised to early versus delayed cord clamping have been limited. Awareness of the benefits for all newborns continues to increase as more studies are published. While many physicians have incorporated delayed cord clamping into practice, there remains a hesitation to implement delayed cord clamping, particularly with full-term infants. As evidence of the safety and benefits of delayed cord clamping are demonstrated, this hesitation should disappear. We applaud Andersson and colleagues for their persistence because their study closes the knowledge gap regarding the long-term safety of delayed cord clamping in healthy full-term newborns. Their important findings suggest that there is an absence of harm that lasts until 4 years of age.”
SOURCE: JAMA Pediatrics
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