Gyorkos et al. (2012)


Cohort study

Pre/Post test model

N = 224 matched pairs (women and infants)

A change in hospital policy toward DCC is effective in improving hemoglobin levels and anemia status of 8-month-old infants.

No difference in hematological status between the pre- and post-intervention groups at 4 months of age perhaps because only after 4 - 6 months of life that the distribution of iron content approaches stability.

Hutton et al. (2013)


Observational study

N = 98 women

Timed clamping of cord in large tertiary care center in Canada. Over half (56.5%) of infants cords clamped within 15 seconds

There was a change in policy guidelines at the center to delay cord clamping. Study should be repeated to determine compliance.

Jahazi et al. (2008)


Double blind randomized study of ECC and LCC neonatal hematocrit

N = 64

Exp = 34

Control = 30

Neonatal hematocrit at 2 h of life and 18 h did not significantly differ between the two groups

In the LCC group, PRBV was lower and ENBV was higher, with no significant difference for polycythemia. Authors used differing definitions of cord clamp timing from standard.

Kohn (2013) [19]

Literature Review on DCC/ICC and PPH

Lack of agreement on definition of ICC and DCC. Examined articles on term and preterm infants and role of PPH.

DCC may be beneficial in areas where iron deficiency is prevalent. No increased risk of PPH.

Mercer et al. (2010)



N = 72 VLBW infants

Male infants with DCC had Psychomotor Developmental Index (PDI) scores an average of 18 points higher compared with infants with ICC. DCC was also associated with protection against IVH and sepsis among male neonates.

Authors suggest follow up of four years.

Scheans (2013) [14]

Literature review Describes the neonatal benefits of DCC (1 - 3 min or until cord stops pulsating)

DCC results in improved iron stores

Asymptomatic polycythemia after birth was more common with DCC, but did not result in significant differences in bilirubin level.

Tonse (2013)

Literature review of current evidence and recommendations

Review of Literature

Follow guidelines from professional bodies, recommend waiting at least 30 seconds to clamp cord

Need more information regarding position of baby at birth, especially in Cesarean birth.

Tonse (2014)

Opinion Comment; The Lancet

Review of literature

ICC is an intervention; obstetricians and midwives should wait two minutes before clamping cord

More research needs to be done in this area.

Vain et al. (2014)


Randomized Trial examining effect of gravity of placental transfusion volumes

N = 546 newborn term infants

E = 194

C = 197

Position of the newborn before cord clamping does not appear to affect volume of placental transfusion

Mothers should be allowed to hold their babies immediately after birth Improve bonding Decrease iron deficiency No adverse events reported.

Weckert et al. (2008)


Literature Review of current evidence

Babies with DCC had increased packed cell volumes, additional iron stores, hemoglobin levels, and ferritin levels up to 6 months old.

Cost effective Non-interventionist


Yao et al. (1969)


Case control study- rate of placental transfusion

111 full term newborns

Within one minute of birth 50% of placental volume infused to newborn. Additional 20 - 35 ml/kg transfused if cord is not clamped for 3 minutes.

Holding the newborn 40 cm below the placenta- transfusion completed in 30 seconds. Transfusion takes longer if infant held higher, but is still completed.