When a baby arrives too early, parents and doctors face tough choices about care. One question is how to handle the umbilical cord—should we clamp it right away or wait? This review looked at that question, focusing on a serious brain bleed called intraventricular hemorrhage (IVH).
Researchers combined data from many studies involving 8,706 preterm babies. They compared strategies like delayed cord clamping, immediate clamping, and milking the cord. The main goal was to see if any method changed the risk of any grade of IVH or severe IVH (grades III-IV).
The findings were consistent: no strategy showed a clear benefit or harm. For example, delayed clamping versus immediate clamping showed no significant difference in risk for any IVH (RR 0.90) or severe IVH (RR 1.14). Comparisons with cord milking also showed no benefit. The certainty of this evidence was low to very low, meaning the results are uncertain due to potential bias and imprecision.
So, what does this mean for families? It suggests that, based on current evidence, no cord management strategy is clearly linked to changing IVH risk. This doesn't settle the question, but it indicates that choices aren't causing obvious harm.