Javier Orenga researches the best moment to clamp the umbilical cord and its relation with iron reserves

 
Javier Orenga, profesor de la Facultad de Enfermería y Podología de la Universitat de València.
Javier Orenga, profesor de la Facultad de Enfermería y Podología de la Universitat de València.

Javier Orenga is a professor of the Faculty of Nursery and Podiatry of the Universitat de València and a nurse specialized in Obstetrics and Gynaecology in the University Hospital of La Plana. He has collaborated in a study whose purpose is to determine the best moment to clamp the umbilical cord of new-born babies. The research has analysed 156 labours in order to establish a relation between the moment in which the clamp is conducted and the iron reserves of the baby and his mother.

The study indicates that the best moment to clamp the umbilical cord under normal conditions is around three minutes after the baby has been born. Thus, possible complications and the increase in the levels of iron can be observed in the baby. This fact reduces the risk to suffer anaemia during the breastfeeding period of the baby. Regarding the mother, the research reports effects linked to her haematological health, her own satisfaction with the labour and a better adherence to lactation.

The study has analysed the effects of a premature clamp (before the baby’s first minute of life) and a late clamp (after the baby’s first minute of life). It takes into account the consequences that this moment can have on the iron reserves for the baby and his mother.

If the clamp takes place after the umbilical cord stops beating, which can occur after the third minute of the baby’s life, there is no evidence of health complications for neither the baby nor the mother.

The study did not report any baby that suffered during the six following months iron deficiency anaemia that needed a supplement of iron. However, the study considers important to postpone the clamp at least until the first minute of the baby’s life because it gives enough time for the iron reserves to be increased and contributes to a natural transition of the baby to his extrauterine life.

This research is included in the book Influencia del tiempo de ligadura del cordón umbilical en la morbilidad secundaria neonatal, los depósitos de hierro en el neonato y lactante, y efectos maternos Asociados. It has been published by the Dávalos Fletcher de Castelló Foundation. This book revises the history of the clamp of the umbilical cord: “according to a millenary habit, the umbilical cordon was generally clamped minutes after the baby was born, when the beating stopped (3-5 minutes after childbirth). A few centuries later, probably when medicine was born in the second half of the 18th century, the clamp tended to be done following the first seconds of the baby’s life,” explains the paediatrician Pasqual Gregori.

This argument was already questioned by early 19th century publications. Nonetheless, this practice is still largely used nowadays. This is the reason why this study, which has been entirely conducted in Castellón, has assessed the relation between an early/late clamp and the baby’s secondary morbidity, his iron reserves and the description of the maternal effects linked to this intervention.  

 

Methodology

The study has analyzed the 156 childbirths. Pregnant women were randomly assigned to one of the study groups (early/late clamp) and they gave birth between March 2015 and December 2016 in the University Hospital of La Plana. Babies were monitored in the postnatal period, 28 days after the birth and 5 or 6 months later.

The clinical test was led by the pediatrician Pasqual Gregori and Javier Orenga. Other collaborators in the study have been Emilio Monteagudo, chief of Paediatrics in La Fe Hospital of Valencia; Paula Sánchez, professor of Biochemistry at the CEU Cardenal Herrera Univeristy and María Angélica Fajardo, coming from the National University of Patagonia in Argentina.

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