Statement on Delayed Umbilical Cord Clamping
Issued: Jan. 10, 2017
The American College of Obstetricians and Gynecologists has released a position statement on delayed cord blood clamping that recommends an interval of 30-60 seconds after delivery of healthy term babies.
The recommendation is based on limited studies that show a beneficial effect on red blood cell stores in the newborn, lessening the risk of iron deficiency anemia later in infancy. The statement also notes that there is a small risk of increased hyperbilirubinemia in some infants after delayed cord clamping. Finally, the statement acknowledges that delayed cord clamping may lessen the amount of placenta blood available for collection for cord blood banking, and that delayed clamping might be aborted to maximize the amount of placental blood available for harvest in directed donation or family banking.
The statement references a report from the National Placental Blood Program at the New York Blood Center showing that fewer publicly donated units met specifications for banking when collected after delayed clamping.
Although the impact of the ACOG statement cannot be foreseen at this time, it is likely that an increased number of obstetrical providers will practice delayed clamping. Mothers who learn about delayed clamping will have the option to request or refuse it.
This new statement has obvious potential implications for cord blood banking. For private/family banking, the benefits of leaving the blood in the umbilical cord will need to be explained. With this knowledge, mothers can decide whether they want the baby to have more blood post-delivery or have the blood available for cord blood storage. For public banking, there is the principle of not interfering with standard-of-care for the baby and mother. Mothers who volunteer to donate their baby’s cord blood to a public bank should be informed about collection with or without delayed clamping. It is her choice whether her obstetrical provider delays clamping after delivery of her baby.
This represents yet another challenge for cord blood banking in general. The impact of the ACOG position statement on routine obstetrical practice will be better understood in the coming months. The CBA will continue to monitor and report on these metrics as they emerge.