From: A physiologic approach to cord clamping: Clinical issues
Population | ||
  Extremely low birth weight/extremely preterm infants | ||
  Infants with evidence of asphyxia – antepartum/intrapartum | ||
  Infants born in low-resource settings | ||
Intervention (delayed cord clamping with multiple covariates) | ||
  Antenatal corticosteroid administration before preterm birth | ||
  Type of maternal anesthesia | ||
  Uterine activity (contractions or operative delivery without labor) | ||
  Administration of uterotonic relative to cord clamping | ||
  Onset of respirations relative to cord clamping | ||
 |    Spontaneous | |
 |    Assisted ventilation | |
  Position of infant relative to placenta | ||
  Duration of delay before clamping | ||
Comparison | ||
Delay in cord clamping with and without resuscitation | ||
 | Initial steps (drying, clearing airway, specific stimulation to breathe) | |
 | Positive-pressure ventilation | |
 |  | Sustained inflation |
 |  | CPAP |
 |  | Intermittent positive-pressure ventilation |
Umbilical cord milking vs. delayed cord clamping | ||
 |   Active milking (length of cord segment, rate, number of passes) | |
 |   Draining of cord segment | |
Outcome | ||
Need for resuscitation | ||
Physiologic characteristics during postnatal stabilization | ||
 |   Temperature | |
 |   Blood pressure | |
 |   Blood glucose | |
 |   Need for volume expanders/pressors (per defined criteria) | |
 |   Regional blood flow – e.g. cerebral | |
Hemoglobin/hematocrit/iron status | ||
Blood volume | ||
Need for transfusion (per defined criteria) | ||
Complications of prematurity | ||
 |   Intracranial hemorrhage/periventricular leukomalacia | |
 |   Necrotizing enterocolitis | |
 |   Bronchopulmonary dysplasia/duration of supplemental oxygen | |
 |   Patent ductus arteriosus | |
Hyperbilirubinemia | ||
 |   Premature and term infants | |
 |   Populations at high risk (genetic variations) | |
 |   Settings with limited access to phototherapy | |
Polycythemia | ||
 |   Term infants and growth-restricted infants | |
 |   Technique-specific differences (delayed clamping vs. umbilical cord milking) | |
Neurodevelopment | ||
 |   Toddler, preschool, elementary school outcomes | |
 |   Sex-specific differences | |
 |   Correlation with iron status | |
 |   Brain microstructure/development (advanced imaging i.e. MRI) | |
Behavior | ||
 |   Prevalence/duration of exclusive breastfeeding | |
Mortality | ||
Maternal obstetrical outcomes | ||
 |   Physiologic characteristics postpartum | |
 |   Postpartum hemorrhage | |
 |   Intraoperative complications |