Late umbilical cord-clamping as an intervention for reducing iron deficiency anaemia in term infants in developing and industrialised countries: a systematic review.
This review evaluates the potential of delayed cord-clamping for improving iron status and reducing anaemia in term infants and for increasing the risk of polycythaemia and hyperbilirubinaemia. We applied a strict search protocol to identify controlled trials of early vs late cord-clamping. Four trials from developing and four from industrialised countries were finally assessed. Two of the four studies from developing countries found a significant difference in infant haemoglobin levels at 2-3 months of age in favour of delayed cord-clamping. This difference was more marked when mothers were anaemic. Three of four studies from industrialised countries showed a significant difference in haematocrit levels in favour of delayed clamping. Although meta-analysis showed an increased risk for hyperbilirubinaemia of 12%, no studies reported the need to apply phototherapy or perform exchange transfusion. We conclude that delayed cord-clamping in term infants, especially those with anaemic mothers, increases haemoglobin concentration in infants at 2-3 months of age and reduces the risk of anaemia, without an associated increased risk of perinatal complications. In developing countries where fetal anaemia is common, the advantages of delayed cord-clamping might be especially beneficial.
Emma Kinderziekenhuis, Academic Medical Centre, Amsterdam, The Netherlands. P.F.vanRheenen@amc.uva.nl
Patrick
P
van Rheenen
Bernard J
BJ
Brabin
D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000517:prevention & control*; D000751:Anemia, Neonatal / Q000097:blood / Q000517:prevention & control*; D003250:Constriction; D019049:Developed Countries; D003906:Developing Countries; D006801:Humans; D007231:Infant, Newborn; D011086:Polycythemia / Q000209:etiology; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D013997:Time Factors; D014470:Umbilical Cord