(P-BT-21) Impact of Delayed Cord Clamping on Cord Blood Collections; A 5 Year Comparative Analysis

Background/Case Studies: Delayed cord clamping (DCC) is the practice of waiting to clamp and cut the umbilical cord after birth, rather than doing so immediately. In 2019, we analyzed DCC times and associated cord blood (CB) collections across the U.S. We are now evaluating whether DCC practices have changed over the past five years and if the impact on CB collections remains consistent.

Study

Design/Methods: Data collection cards were included in CB collection kits distributed nationally and completed by medical professionals. Participants indicated whether DCC was performed and the delay duration. Data were categorized as: no delay, yes < 1 minute, yes 1–3 minutes, yes >3 minutes, and yes time unknown. The initial dataset (A) includes over 22,000 cases, compared with a more recent cohort of nearly 40,000 cases (B), analyzed in 2024. Together, these datasets offer robust insight into DCC practices across the U.S.

Results/Findings: In Dataset A, 42% of collectors reported not performing DCC. The remaining 58% delayed clamping: 42% for < 1 minute, 12% for 1–3 minutes, 2% for >3 minutes, and 2% with unknown duration.
In 2024’s Dataset B, only 25% reported not performing DCC. The remaining 75% delayed clamping: 64% for < 1 minute, 10% for 1–3 minutes, and 1% for >3 minutes.
CB collection volumes in Dataset A averaged 99.6ml (no delay), 90.4ml (< 1 min), 85.9ml (1–3 min), and 80.1ml ( >3 min).
In Dataset B, averages were 100.9ml, 90.7ml, 86.4ml, and 78.3ml, respectively.
There was no statistically significant difference in collection volume between datasets A and B in any DCC category with p values of 0.36 (< 1 min) , 0.44 (1-3 min) and 0.41( >3 min).

Conclusions: Over the past five years, there has been a 17% overall increase in DCC, with a notable shift toward delay of < 1 minute, aligning with current ACOG guidelines. The analysis of over 60 thousand CB collections and associated data informs us that when DCC is performed for < 1 minute, it results in an average 9-10ml reduction in CB volume compared to collections where there is no delay. Average CB collection volumes remain consistent with previous findings across all delay categories. Since total nucleated cell count correlates with volume, these findings highlight the importance of balancing the benefits of DCC with its implications for CB collection quality.