10/26/2025
ACOG PUBLICATIONS
ACOG Clinical Practice Update: An Update to Clinical Guidance for Delayed Umbilical Cord Clamping After Birth in Preterm Neonates
Author Information
Obstetrics & Gynecology 146(3):p 442-444, September 2025. | DOI: 10.1097/AOG.0000000000006020
ACOG Clinical Practice Update: An Update to Clinical Guidance for Delayed Umbilical Cord Clamping After Birth in Preterm Neonates, 9/2025:
•Defer umbilical cord clamping for at least 60 seconds in preterm neonates born at less than 37 weeks of gestation who are deemed not to require immediate resuscitation at birth.
•In preterm neonates born at 28 0/7–36 6/7 weeks of gestation who do not receive deferred cord clamping, umbilical cord milking is a reasonable alternative to immediate cord clamping to improve neonatal hematologic outcomes.
ACOG CO 814:
•In term infants, delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes. •Delayed umbilical cord clamping is associated with significant neonatal benefits in preterm infants, including improved transitional circulation, better establishment of red blood cell volume, decreased need for blood transfusion, and lower incidence of necrotizing enterocolitis and intraventricular hemorrhage. •Given the benefits to most newborns and concordant with other professional organizations, the American College of Obstetricians and Gynecologists now recommends a delay in umbilical cord clamping in vigorous term and preterm infants for at least 30–60 seconds after birth.
•There is a small increase in the incidence of jaundice that requires phototherapy in term infants undergoing delayed umbilical cord clamping. Consequently, obstetrician–gynecologists and other obstetric care providers adopting delayed umbilical cord clamping in term infants should ensure that mechanisms are in place to monitor and treat neonatal jaundice.
•Delayed umbilical cord clamping does not increase the risk of postpartum hemorrhage.
ACOG PUBLICATIONS
ACOG Clinical Practice Update: An Update to Clinical Guidance for Delayed Umbilical Cord Clamping After Birth in Preterm Neonates
Author Information
Obstetrics & Gynecology 146(3):p 442-444, September 2025. | DOI: 10.1097/AOG.0000000000006020
Abstract
This Clinical Practice Update provides guidance related to management of the umbilical cord at birth based on recently published data regarding short, medium, and long deferral of cord clamping; cord milking; and immediate cord clamping in preterm neonates. In this document, the terms “deferred” and “delayed” are used interchangeably as they relate to management of the cord at birth. This document updates Committee Opinion No. 814, Delayed Umbilical Cord Clamping After Birth (Obstet Gynecol 2020;136:e100–6).
