Delaying cord clamping is associated with what risk in neonates?

• A. Delayed cord clamping is associated with polycythemia in neonates.
• B. It reduces risk of polycythemia.
• C. It has no effect on hematocrit.
• D. It is contraindicated in all preterm infants.

Answer: (A)

Delaying cord clamping increases the amount of blood transferred from the placenta to the baby, boosting the newborn’s blood volume and red cell mass. That higher hematocrit can lead to polycythemia, a state where the blood is more viscous. Hyperviscosity can slow flow in the tiny vessels, contributing to symptoms such as respiratory distress, jitteriness or irritability, cyanosis, and feeding difficulties, and it can also worsen hyperbilirubinemia from increased red cell turnover. So the main risk associated with delaying clamping is polycythemia. It’s not about having no effect on hematocrit, and it doesn’t mean delaying clamping is universally contraindicated in all preterm infants—the decision is individualized, weighing benefits against this risk.