More concerns about umbilical cord clamping

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Posted:  January 20, 2023 06:44 PM

Umbilical cord clamping is a human invention; many questions need to be asked:

(1) The Apgar score – This method of rating the condition of newborn babies may have resulted from adoption of a policy in the early 1950s at the Sloane Hospital in New York to clamp the cord within the first minute after birth:

Apgar V et al. (1958) Evaluation of the newborn infant – second report. JAMA 168(15):1985-1989

(2) Fears of jaundice - The protocol for immediate clamping of the cord may have come from research (mainly with premature infants) seeming to indicate that polycythemia and excess bilirubin can result if "placental transfusion" is allowed to occur:

Saigal S et al. (1972) Placental transfusion and hyperbilirubinemia in the premature. Pediatrics 49:406-19
Saigal S, Usher RH (1977) Symptomatic neonatal plethora. Biol Neonate 32:62-72

This perspective has recently been modified to "wait a minute" – see:
Philip AGS, Saigal S. When should we clamp the umbilical cord? NeoReviews 5(4):e142-e153.

Following are some online letters Dr. Morley and I have submitted on this and related topics: When to clamp the cord, Neonatal transfusion, and Is bilirubin the real cause of kernicterus?

(3) Human assisted births of thoroughbred foals - The only other species in which clamping of the umbilical cord has been tried is in the breeding of race horses. Disorientation and respiratory problems in newborn foals were attributed to diminished blood volume. The neuropathology resembles that found in newborn monkeys subjected to asphyxia at birth:

Mahaffey LW, Rossdale PD (1957) The newborn infant’s oxygen supply. Lancet 1957 Jul 13;2:95.
Mahaffey LW, Rossdale PD (1959) A convulsive syndrome in newborn foals resembling pulmonary syndrome in the newborn infant. Lancet. 1959 Jun 13;1(7085):1223-5.
Palmer AC, Rossdale PD. (1975) Neuropathology of the convulsive foal syndrome. J Reprod Fertil Suppl. 1975 Oct;(23):691-4.

Eileen Nicole Simon