Umbilical cord clamping in the early phases of the COVID-19 era - A systematic review and meta-analysis of reported practice and recommendations in guidelines.
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Berg J, Thies-Lagergren L, Svedenkrans J, Samkutty J, Larsson SM, Mercer JS, Rabe H, Andersson O, Zaigham M
Int J Infect Dis - (-) -
[2023-10-13; online 2023-10-13]
In the beginning of the COVID-19 pandemic, delayed umbilical cord clamping (CC) at birth may have been commonly discouraged despite a lack of convincing evidence of mother-to-neonate SARS-CoV-2 transmission. We aimed to systematically review guidelines, reports of practice and to analyze associations between timing of cord clamping and mother-to-neonate SARS-CoV-2 transmission during the early phases of the pandemic. Major databases were searched December 1, 2019 to July 20, 2021. studies and guidelines describing cord clamping practice in women with SARS-CoV-2 infection during pregnancy until two postnatal days, giving birth to live born neonates. no extractable data. Two reviewers independently screened studies for eligibility and assessed study quality. Pooled prevalence rates were calculated. Forty-eight studies (1476 neonates) and 40 guidelines were included. Delayed CC was recommended in 70.0% of the guidelines. Nevertheless, delayed CC was reported less often than early CC: 262/1476 (17.8%) vs. 511/1476 (34.6%). Neonatal SARS-CoV-2 positivity rates were similar following delayed (1.2%) and early CC (1.3%). Most SARS-CoV-2 transmissions (93.3%) occurred in utero. Delayed CC did not seem to increase mother-to-neonate SARS-CoV-2 transmission. Due to its benefits, it should be encouraged even in births where the mother has a SARS-CoV-2 infection.
PubMed 37839504
DOI 10.1016/j.ijid.2023.10.010
Crossref 10.1016/j.ijid.2023.10.010
pii: S1201-9712(23)00747-6