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Delayed cord clamping did not affect long-term iron status, neurodevelopment in infants
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Delayed cord clamping did not appear to influence iron status or neurodevelopment at age 1 year, according to a study of healthy term-born infants.
Iron deficiency is linked with serious complications, including iron deficiency anemia and suboptimal development. Delayed cord clamping prevents iron deficiency during the first 6 months of life, but the long-term effects of the timing of umbilical cord clamping on infant outcomes remain unclear, according to background information in the study.
Ola Andersson, MD, PhD, of the department of Women’s and Children’s Health at Uppsala University in Sweden, and colleagues compared iron status and neurodevelopment outcomes among 347 full-term infants.
Researchers observed no differences in iron status between those who received delayed cord clamping and those who received early cord clamping (mean ferritin level, 35.4 ng/mL vs. 33.6 ng/mL; P=.40). The investigators also reported no significant difference in neurodevelopment between groups (mean Ages and Stages Questionnaire total score, 229.6 vs. 233.1; P=.42).
Overall, boys were more likely to have lower ferritin levels and neurodevelopment scores.
Interaction analysis showed girls who underwent delayed cord clamping scored a mean 12 points lower on the Ages and Stages Questionnaire than those who underwent early cord clamping (230 vs. 242 out of a maximum 300 points). Boys who underwent delayed cord clamping scored a mean 5 points higher than those who underwent early cord clamping (229 vs. 224; P=.04 for the interaction term).
“Future research in this area should be directed at studying development at later ages, and at assessing long-term effects of delayed cord clamping on iron status and development in communities with higher rates of iron deficiency and anemia,” Andersson and colleagues wrote. “The possible reverse effect on girls’ and boys’ development might also be taken into account.”
Disclosure:The researchers report no relevant financial disclosures.
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Ralph Green, MD, PhD
Given that iron deficiency during infancy and beyond is undesirable, it would seem obvious that delayed umbilical cord clamping would be beneficial, allowing the newborn infant to retain more of his or her birthright of iron bequeathed through siphoning of maternal iron stores. It is, therefore, somewhat surprising that no clear beneficial effects on iron status or neurodevelopment were seen at 12 months when comparing delayed with early cord clamping. This was even more surprising because these investigators had previously reported improved iron storage status in the same cohort of infants when they were 4 months of age. That the beneficial effect did not last implies that the small gain accrued by delayed clamping does not endure. What is intriguing, however, is that delayed cord clamping appeared to have a differential effect depending on gender. Regarding neurodevelopment, whereas boys did better, girls did worse after delayed clamping — a curious and totally unexplained sex difference.
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