title: Placental blood transfusion in newborn babies reaches a plateau after 140 s: Further analysis of longitudinal survey of weight change.
abstract: OBJECTIVE
  With the introduction of active management of the third stage of labour in the 1960s, it became usual practice to clamp and cut the umbilical cord immediately following birth. The timing of this cord clamping is controversial, as blood may beneficially be transferred to the baby if clamping of the cord is delayed slightly. There is no agreement, however, on how long the delay should be before clamping the cord. This study aimed to establish when blood ceased to flow in the umbilical cord to determine how long to delay clamping of the umbilical cord following delivery of the term newborn to maximise placental transfusion.
  
  
  METHODS
  This observational study collected longitudinal weight measurements set in a hospital labour ward. A total of 26 mothers at term and their singleton babies participated in the study. In this reanalysis, the velocity of weight change over the first minutes of life determined by functional data analysis was estimated.
  
  
  RESULTS
  We found that the flow velocity in the umbilical cord was on average 0 at 125 s after placing the baby on the scales, which was typically 140 s after birth.
  
  
  CONCLUSIONS
  To maximise placental transfusion, cord clamping should be delayed for at least 140 s following birth of the baby.
authors.affiliation: Division of Biostatistics, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK.
authors.forename: Graham R
authors.initials: GR
authors.lastname: Law
authors.affiliation: Division of Biostatistics, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK.
authors.forename: Brian
authors.initials: B
authors.lastname: Cattle
authors.affiliation: Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK.
authors.forename: Diane
authors.initials: D
authors.lastname: Farrar
authors.affiliation: Division of Diabetes and Cardiovascular Research, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK.
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Scott
authors.affiliation: Division of Biostatistics, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Gilthorpe
keywords: Placental transfusion; birth; functional data analysis; labour; neonate