When is the best time to clamp the umbilical cord after routine vaginal delivery?
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Sometime between 30 seconds and 2 minutes after delivery appears to be the best interval. In term infants, delayed clamping (waiting 1 or 2 minutes or until the cord stops pulsating) improves hemoglobin and ferritin levels, but slightly increases the risk of neonatal jaundice requiring phototherapy (strength of recommendation [SOR]: A, meta-analysis). In preterm infants less than 37 weeks of age, cord clamping between 30 and 120 seconds after delivery reduces the need for blood transfusion (number needed to treat [NNT]=4) and frequency of intraventricular hemorrhage (NNT=8) compared with clamping in less than 20 seconds (SOR: A, meta-analyses).
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