Role of Delayed Cord Clamping in Limiting Blood Transfusion in Preterm Babies’: A Series of Three Nigerian Cases

Nwokeforo U Nathan

Department of Paediatrics, Federal Medical Centre Umuahia, Abia state, Nigeria and Accord Childrens Clinic, Owerri, Imo state, Nigeria.

Ezuruike O Ezinwa *

Department of Paediatrics, Federal Medical Centre Umuahia, Abia state, Nigeria.

Okorochukwu Bartholomew

Vaden Specialists Clinics Owerri, Imo state, Nigeria.

Onumajuru Chiemeka

Department of Obstetrics and Gynaecology, Federal Teaching Hospital Owerri, Imo state, Nigeria.

*Author to whom correspondence should be addressed.


The management of preterm babies are usually challenging with one significant issue being anaemia, which often requires multiple blood transfusions and their associated complications. Delayed cord clamping during delivery have been identified as a proactive measure to reduce the need for multiple blood transfusion in preterm babies. We present three case series of preterm babies delivered and managed with intentional delayed cord clamping [DCC], to strengthen the advocacy for the practice particularly in developing and less developed nations where blood transfusion facilities and practice may be inadequate.

Keywords: Blood transfusion, preterm, delayed cord clamping

How to Cite

Nathan, Nwokeforo U, Ezuruike O Ezinwa, Okorochukwu Bartholomew, and Onumajuru Chiemeka. 2024. “Role of Delayed Cord Clamping in Limiting Blood Transfusion in Preterm Babies’: A Series of Three Nigerian Cases”. International Journal of TROPICAL DISEASE & Health 45 (7):104-8.


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Zhang J, Sun K, Zhang Y. The rising preterm birth rate in China: A cause for concern. Lancet Glob Health. 2021; 9:e1179-1180.

Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A-B, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: A systematic analysis and implications. Lancet. 2012;379 (9832):2162–72.

Chawanpaiboon S, Vogel JP, Moller A, Lumbiganon P, Petzold M, Hogan D et al. Global, regional, and national estimates of levels of preterm birth in 2014: A systematic review and modelling analysis. Lancet Glob Health 2019;7(1):e37–46.

Bello M, Pius S, Ibrahim BA, Ibrahim HA. Preterm Babies: Management and challenges associated with survival in a resource-limited setting. WAJM. 2020;37(4):402–406.

García C, Prieto MT, Escudero F, Bosh-Giménez V, Quesada L, Lewanczyk M, Pertegal M, Delgado JL, Blanco-Carnero JE, De Paco Matallana C. The impact of early versus delayed cord clamping on hematological and cardiovascular changes in preterm newborns between 24 and 34 weeks’ gestation: A randomized clinical trial. Archives of Gynecology and Obstetrics. 2023 Jul 12;1-8.

Strauss RG. Anaemia of prematurity: Pathophysiology and treatment. Blood Rev. 2010;24(6):221-225.

DOI: 10.1016/j.blre.2010.08.001

Fogarty M, Osborn DA, Askie L, Seidler AL, Hunter K, Lui K et al. Delayed vs early umbilical cord clamping for preterm infants: A systematic review and meta-analysis. Am J Obstet Gynecol. 2018;218(1):1-18.

DOI: 10.1016/j.ajog.2017.10.231

Lemyre B, Sample M, Lacaze-Masmonteil T; Canadian paediatric society, Fetus and newborn committee. Minimizing blood loss and the need for transfusions in very premature infants. Paediatr Child Health. 2015 Nov-Dec;20(8):451-62. DOI: 10.1093/pch/20.8.451

Rabe H, Diaz-Rosello JL, Duley L, Dowswell T. Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Cochrane Database Syst Rev. 2012;9:CD003248.

Ghavam S, Batra D, Mercer J, Kugelman A, Hosono S, Oh W et al. Effects of placental transfusion in extremely low birthweight infants: Meta-analysis of long- and short-term outcomes. Transfusion 2014;54:1192–1198.

DOI: 10.1111/trf.12469

Tewari VV, Saurabh S, Tewari D, Gaurav K, Kunwar BRB, Khashoo R et al. Effect of delayed umbilical cord clamping on hemodynamic instability in preterm neonatesbelow 35 weeks. J. of Trop Pediatr. 2022;68(3):1–9.


Pan American Health Organization and World Health Organization Regional Office for the Americas. Beyond survival: integrated delivery care practices for long-term maternal and infant nutrition, health and development. 2nd ed. Washington, DC: Pan American Health Organization; 2013.


Chan S, Duck M, Frometa K, Liebowitz M, Rosenstein MG, Tesfalul M, et al. Improving the rate of delayed cord clamping in preterm infants: A quality improvement project. Hosp Pediatr. 2023;13(4): 292-299. DOI: 10.1542/hpeds.2022-006633

World Health Organisation. Guideline: Delayed umbilical cord clamping for improved maternal and infant health and nutrition outcomes. Geneva: World Health Organization; 2014.

Ubuane PO, Mogba OE, Akinola AO, Imam, Z, Kehinde OA, Alaje E, et al. Practice of delayed cord clamping among skilled birth attendants attending a neonatal resuscitation workshop in Lagos, Nigeria: A preliminary exploratory survey. Ann of Clinical Sciences. 2022;7(1):57-61.

Payne L, Walker K, Mitchell E. Timing of umbilical cord clamping for preterm infants in low-and-middle-income countries: A survey of current practice. Euro J Obstet Gynecol Reprod Biol. 2021;264. DOI: 10.1016/j.ejogrb.2021.06.041

Bhikadiya, MS, Shah SG, Gohil J. Delayed vs early umbilical cord clamping in 100 preterm infants: An RCT from Bhavnagar, Gujarat; 2022. DOI: 10.32388/YZHQXI