NEW YORK (Reuters Health) - A slight delay in cutting the umbilical cord of a preterm infant may reduce the need for blood transfusions and prevent brain hemorrhage, according to a new report in.

The timing of umbilical cord clamping is a balancing act, Dr. Heike Rabe, of Brighton and Sussex University Hospitals in Brighton, England, and colleagues point out in the journal of the Cochrane Library.

Preemies require immediate resuscitation, so clamping late can interfere with this as well as raise the risk of lung problems and blood thickening; clamping immediately may deprive the baby of blood from the placenta, increasing the danger of anemia or low blood pressure requiring transfusion.

The investigators reviewed past studies of preterm infants that compared immediate clamping with clamping within 30 to 120 seconds after birth. There were seven studies that included a total of 297 infants.

Compared with immediate clamping, delayed clamping reduced the risk of a blood transfusion by half and cut the risk of brain hemorrhage by almost as much.

"Particularly in developing countries where resources are limited, and the risk of infection (being spread through) transfusion is high, these potential benefits of delayed cord clamping are of paramount importance," the authors note.

However, the trials were too small to reach any firm conclusion about possible lung or stomach effects, or risk of death.

SOURCE: Cochrane Database of Systematic Reviews, October 2004.

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