{
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  "id": "maternal:delayed-cord-clamping",
  "owner": "maternal",
  "kind": "intervention",
  "slug": "delayed-cord-clamping",
  "name": "Delayed umbilical cord clamping",
  "aliases": [
    "Delayed cord clamping",
    "Late cord clamping"
  ],
  "atlases": [
    "maternal"
  ],
  "summary_plain": "Waiting before clamping and cutting the umbilical cord after birth. In the large trial recorded here, which enrolled babies expected to be born before 30 weeks, waiting at least 60 seconds did not lower the chance of death or serious complications compared with clamping within 10 seconds.",
  "summary_technical": "The Australian Placental Transfusion Study (NEJM 2017) randomised fetuses of women expected to deliver before 30 weeks to clamping within 10 seconds or at least 60 seconds after delivery. The combined outcome of death or major morbidity by 36 weeks was 37.0% with delayed clamping and 37.2% with immediate clamping (relative risk 1.00, 95% CI 0.88 to 1.13). PREMOD2 (JAMA 2019) compared cord milking with delayed clamping; its safety signal belongs to cord milking and sits on the PREMOD2 record. This atlas holds no evidence for term babies.",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-14",
  "last_evidence_check": null,
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  "identifiers": [],
  "navigation": {
    "maternal": {
      "life-stage": [
        "childbirth",
        "newborn"
      ],
      "care-area": [
        "newborn-care"
      ]
    }
  },
  "payload": {
    "subtype": "procedure",
    "mechanism": null,
    "components": null
  },
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      "owner": "maternal",
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      "category": "effect",
      "statement": "In the Australian Placental Transfusion Study, delayed cord clamping (at least 60 seconds after delivery) did not lower the combined outcome of death or major morbidity by 36 weeks in babies expected before 30 weeks, compared with immediate clamping (within 10 seconds): 37.0% against 37.2%, relative risk 1.00 (95% CI 0.88 to 1.13). Death alone was 6.4% against 9.0% (P=0.03 in unadjusted analyses and P=0.39 after post hoc adjustment for multiple secondary outcomes).",
      "context": {
        "id": "maternal:ctx-apts-infants-before-30-weeks",
        "label": "Infants born before 30 weeks of gestation (APTS trial)",
        "recipient": "newborn",
        "population": "Fetuses of women expected to deliver before 30 weeks of gestation, randomised before birth. Of 1634 fetuses randomised, 1566 were born alive before 30 weeks and are the infants analysed.",
        "care_setting": "Not stated in the abstract. The trial registry named in the abstract is the Australian and New Zealand Clinical Trials Registry.",
        "geography": "Not stated in the abstract (the registry named is Australian and New Zealand).",
        "life_stage_note": "Preterm infants born before 30 weeks of gestation; the intervention is the timing of cord clamping at delivery",
        "life_stage_terms": {
          "maternal": [
            "newborn"
          ]
        },
        "gestational_age_min_days": null,
        "gestational_age_max_days": 209,
        "gestational_age_basis": "at_birth",
        "postnatal_age_min_days": null,
        "postnatal_age_max_days": null,
        "gestational_age_status": null,
        "postnatal_age_status": null,
        "followup_description": "Death or major morbidity by 36 weeks of postmenstrual age; complete data on the primary outcome were available for 1497 infants (95.6%).",
        "eligibility": {
          "inclusion": [
            "Women expected to deliver before 30 weeks of gestation"
          ],
          "exclusion": []
        }
      },
      "evidence_stage": "interventional",
      "certainty": "not_assessed",
      "certainty_method": null,
      "limitations": "The trial enrolled only babies expected before 30 weeks, so the result does not apply to term or later preterm babies. The mortality difference was not significant after adjustment for multiple secondary outcomes. The median time to clamping was 5 seconds and 60 seconds in the two groups. Only the abstract was read.",
      "editorial_state": "draft",
      "checked_at": null,
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