Delaying the clamping of the umbilical cord at least 3 minutes after birth appears to improve social and fine motor skills in children at age 4 years, a follow-up study showed.

No differences in IQ were found, however, between those with early vs. delayed cord clamping.

“The included children constitute a group of low-risk children born in a high-income country with a low prevalence of iron deficiency,” Dr. Ola Andersson of Uppsala (Sweden) University and her associates wrote ( JAMA Pediatr. 2015 May 26 [doi:10.1001/jamapediatrics.2015.0358] ). “Still, differences between the groups were found, indicating that there are positive, and in no instance harmful, effects from delayed cord clamping,” they added. “Delaying umbilical cord clamping by 2-3 minutes after delivery allows fetal blood remaining in the placental circulation to be transfused to the newborn.”

In the original trial, 382 term infants from low-risk pregnancies were randomized to have their umbilical cords clamped within 10 seconds after birth or else at least 3 minutes after birth at a Swedish county hospital between April 2008 and May 2010. Four years later, 263 children underwent IQ testing with the Wechsler Preschool and Primary Scale of Intelligence and motor skills testing with the Movement Assessment Battery for Children. In addition, parents filled out questionnaires regarding the children’s behavior and developmental stages.

Average IQ scores did not differ between the two groups, but fewer children in the delayed cord-clamping group had an immature pencil grip: 13.2% percent, compared with 25.6% of those who had immediate cord clamping. Further, 3.8% of children who had delayed clamping and 12.9% of children who had immediate clamping fell below average on another fine motor test (the bicycle-trail task).

“In girls, there were no differences between the groups for any of the assessments. An at-risk result in the bicycle-trail task was less prevalent in boys who received delayed cord clamping, compared with those who received early cord clamping (3.6% vs. 23.1%); findings were similar in the Ages and Stages Questionnaire, Third Edition, fine-motor domain (8.9% vs 23.6%),” Dr. Andersson and her associates wrote.

“The effect by sex is consistent with previous results from the same study population at 12 months,” they said, because past studies have shown lower iron stores in boys, compared with girls, at birth and in infancy.

The research was funded by the Regional Scientific Council of Halland, the Linnéa and Josef Carlsson Foundation, the Southern Health care Region, H.R.H. Crown Princess Lovisa’s Society for Child Care, Uppsala University, the Little Childs Foundation, and the Swedish Research Council for Health, Working Life, and Welfare. The authors reported no relevant financial disclosures.

obnews@frontlinemedcom.com

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