Better chance for premature babies if their cords aren't clamped right away

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Auckland City Hospital has changed its procedures. Photo credit: Getty

Dozens of Kiwi babies born prematurely could be saved every year by waiting a minute before clamping the umbilical cord.

That's the conclusion of a years-long study involving researchers and parents here and in Australia, which this week was given the Australian Clinical Trials Alliance clinical trial of the year award.

Around 700 babies are born severely prematurely - 32 weeks' gestation or less - every year in New Zealand, and about 100 of them die.

The study found that if a pre-term baby's umbilical cord was left intact for at least a minute before cutting it, they had a 30 percent better chance of surviving than if it was cut immediately, as has been standard practise.

The World Health Organisation already recommends waiting a minute, and not just for preterm babies, because it allows more blood from the placenta to flow into the newborn, bringing more iron and oxygen with it.

"The extra blood at birth helps the baby to cope better with the transition from life in the womb, where everything is provided for them by the placenta and the mother, to the outside world,"  neonatologist Heike Rabe said in 2015, when research done in the UK was published that came to a similar conclusion as this latest study.

"Their lungs get more blood so that the exchange of oxygen into the blood can take place smoothly."

Auckland City Hospital has changed its procedures, and obstetrician Katie Groom - who participated in the study - hopes more will follow.

"We know Auckland City Hospital has and we hope more will as word gets out," Dr Groom told NZME.

Newshub has contacted the Ministry of Health for its latest guidelines on the practise.

In 2015, the Maternity Services Consumer Council said "far too many" midwives and obstetricians were still cutting the cord right away. In 2011, statistics show at 90 percent of vaginal births, at the labour stage, were being managed "actively", which usually involves cutting the cord in the first minute. By 2016, that had fallen only slightly to 89 percent.

"There is no, and never has been, any evidence to support the practice of clamping the cord before it has stopped pulsating," the Maternity Services Consumer Council said in a statement.

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Around 700 babies are born severely prematurely in NZ every year. Photo credit: Getty

But why are umbilical cords being clamped and cut immediately in the first place? Because of fears of hypothermia, jaundice, delayed resuscitation and polycythemia (too many red blood cells) for the baby, and internal bleeding for the mother.

The study (and those before it) found while there is a minor increase in the risk of jaundice and polycythemia, the trade-offs are worth it - babies are more likely to survive and less likely to suffer anaemia or require a transfusion, and no link between delayed cutting and internal bleeding in the mother has been found.

"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 co-author and University of Sydney professor David Osborn.

If practised worldwide, delayed clamping would save between 11,000 and 100,000 births a year, Prof Osborn estimated.

The research was published in October in the American Journal of Obstetrics and Gynecology.

Newshub.

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