Preterm infants are 32% less likely to die with delayed versus immediate umbilical cord clamping, according to Australian researchers who say their findings will inform clinical practice guidelines.

They also found that waiting at least two minutes before cord clamping — rather than at least 60 seconds or until pulsation stops, as per current RANZCOG guidance — led to the largest mortality reduction.

“We found high-certainty evidence that deferred cord clamping reduces death before discharge in preterm infants, and this effect is consistent across different population groups,” the authors wrote in The Lancet.

In a systematic review and meta-analysis of 48 trials with nearly 6400 preterm infants, the University of Sydney-led team compared the risks of deferred cord clamping, immediate clamping and cord milking.