60 seconds to save thousands of preterm babies' lives

A simple 60-second wait before clamping a preterm baby’s umbilical cord could save the lives of thousands of preterm babies, according to two new Australian-led studies.

“We estimate that for every thousand very preterm babies born more than 10 weeks early, delayed clamping will save up to 100 additional lives compared with immediate clamping,” said the University of Sydney’s Associate Professor David Osborn, the review’s lead author and a neonatal specialist at Royal Prince Alfred Hospital.

“This means that, worldwide, using delayed clamping instead of immediate clamping can be expected to save between 11,000 and 100,000 additional lives every year.”

The results are from two international studies supported by hundreds of parents and professionals worldwide and coordinated by the National Health and Medical Research Council Clinical Trials Centre, Sydney.

Approved for publishing in the American Journal of Obstetrics and Gynecology, the review, led by University of Sydney researchers, assessed morbidity and mortality outcomes from 18 trials comparing delayed versus immediate cord clamping in nearly 3000 babies born before 37 weeks’ gestation. It found clear evidence that delayed clamping reduced hospital mortality by a third and is safe for mothers and preterm infants.

The review also reported that delayed clamping reduced subsequent blood transfusions and increased neonatal hematocrit, confirming that placental transfusion occurred.

“The review shows for the first time that simply clamping the cord 60 seconds after birth improves survival,” said the University of Sydney’s Professor William Tarnow-Mordi, senior author.

“It confirms international guidelines recommending delayed clamping in all preterm babies who do not need immediate resuscitation.”

The systematic review confirms new findings from the Australian Placental Transfusion Study, published this week in the New England Journal of Medicine, reporting that delayed clamping might reduce mortality before 36 weeks — tentative evidence that required confirmation by an updated review of all relevant trials.

“This is so significant as it is such a simple technique, suitable for almost all preterm babies, that helps saves lives,” said University of Sydney’s Professor Jonathan Morris, co-author of the Australian Placental Transfusion Study.

Information for parents

Parents who want to know more are encouraged to visit the NHMRC Clinical Trials Centre website at www.ctc.usyd.edu.au or Miracle Babies Foundation at www.miraclebabies.org.au for frequently asked questions about the Australian Placental Transfusion Study. Parents in Australia who need support can contact the Miracle Babies Foundation 24-hour helpline at 1300 622 243.

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