Deferred Cord Clamping to Reduce Need for Neonatal Blood Transfusion: the Transfusions In The APTS Newborns Study (TITANS)

Abstract

The Australian Placental Transfusion Study (APTS) and other studies provide strong evidence that deferring umbilical cord clamping at birth for up to a minute is a simple, safe procedure that reduces the proportion of preterm infants who need a blood transfusion by 10%. The mechanism is not fully understood – but one potential mechanism is an increased volume of transfusion of blood from the placenta to the baby after birth. Alternatively, deferred cord clamping may reduce severity of illness in the first weeks after birth. This could lead to fewer blood tests, greater tolerance of anaemia, and better opportunities for babies to make their own red cells. The Transfusions In The APTS Newborns Study (TITANS) is designed is to obtain and analyse more data about the babies in APTS to investigate the mechanism behind the reduced need for red cell transfusions, and to explore whether there are other changes in clinical care that could reduce the need for transfusion.