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Am J Perinatol
DOI: 10.1055/a-2815-9816
Short Communication

Deferred Cord Clamping and Weight Difference for Very Preterm Infants

Authors

  • Mary K. Quinn 

    1   Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Stanford, California, United States

  • Anup C. Katheria

    2   Neonatal Research Institute, Sharp Mary Birch Hospital for Women and Newborns, San Diego, California, United States

  • Jochen Profit

    1   Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Stanford, California, United States
    3   California Perinatal Quality Care Collaborative, Palo Alto, California, United States

  • Henry C. Lee

    4   Department of Pediatrics, University of California, San Diego, California, United States

Funding Information Research reported in this manuscript was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health (grant no.: 1F32HD111260) and by the Stanford Maternal and Child Health Research Institute.
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Abstract

Objective

The objective of this study is to estimate the difference in first-recorded weight associated with deferred cord clamping (DCC) among very preterm infants (< 32 weeks' gestational age) using real-world neonatal intensive care unit data

Study Design

Retrospective cohort study using the California Perinatal Care Collaborative data from 2016 to 2023 across 138 hospitals. Infants with gestational ages between 22 and 316/7 weeks were included. Exclusions were cord milking, death in the delivery room, or missing data. DCC exposure was defined as a delay in cord clamping of at least 30 seconds. Analyses used linear regression adjusting for gestational age (in days) as a second-order polynomial and intrauterine growth restriction (IUGR).

Results

Of 39,013 eligible infants, 6,626 were excluded (cord milking, delivery room deaths, and missing DCC information), leaving 32,387 very preterm infants for the analysis. The mean weight for infants who received DCC was 1,338 g (standard deviation [SD]: 404) compared with 1,290 g (SD: 431) for those who did not. After adjusting for gestational age and IUGR, DCC was associated with 24-g higher first-recorded weight (95% confidence interval: 18–29).

Conclusion

In very preterm infants, at least 30 seconds of DCC is associated with a modest increase (24 g) in first-recorded weight. This finding reinforces evidence from small clinical trials showing increased blood volumes and weight gains attributed to DCC.

Key Points

  • DCC of at least 30 seconds is linked to 24 g higher weights in very preterm infants.

  • Weight gain from DCC is modest but aligns with prior physiological evidence.

  • Real-world evidence on DCC's impact on early weight is limited.

Keywords

umbilical cord management - neonatal health - placental transfusion

Data Availability Statement

Deidentified individual participant data will not be made available due to hospital privacy agreements.


Contributors' Statement

M.K.Q.: Conceptualization, data curation, formal analysis, investigation, methodology, project administration, writing—original draft, writing—review and editing. A.C.K.: Conceptualization, investigation, supervision, writing—original draft, writing—review and editing. J.P.: Conceptualization, investigation, resources, supervision, writing—review and editing. H.C.L.: Conceptualization, investigation, methodology, project administration, supervision, writing—original draft, writing—review and editing.




Publication History

Received: 24 November 2025

Accepted: 17 February 2026

Accepted Manuscript online:
20 February 2026

Article published online:
05 March 2026

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