As a pregnant mother, you will often find yourself submerged in information related to pregnancy and birth, your well-being and that of your growing baby.
If you experience a high-risk pregnancy, affected by a condition such as hemolytic disease of the fetus and newborn (HDFN) there will be extra layers of information to process.
Cord clamping is often used to boost a baby’s red blood cells and iron levels, and as a result, improve developmental outcomes.
What is HDFN?
Hemolytic disease of the fetus and newborn (HDFN) is an immune-mediated red blood cell disorder that occurs when a baby’s RBCs break down quickly, which is called hemolysis. HDFN is caused by a mismatch between a mother’s and her baby’s blood type (A, B, AB, or O) or Rhesus (Rh) factor (Rh-positive or Rh-negative) during pregnancy.
What is delayed cord clamping?
Delayed cord clamping refers to waiting two to three minutes before clamping the umbilical cord following delivery. While the umbilical cord is still pulsating, the circulation from the placenta continues during the first minutes of a baby’s life, passing nutrient-rich placental blood to the newborn.
In standard practice, the cord is clamped within the first minute after delivery, so if you would like your healthcare team to delay cord clamping, you will need to include it in your birth plan and make sure you notify your care team.
The benefits of delayed cord clamping
Delayed cord clamping is beneficial to preterm and full-term newborns and is recommended by the World Health Organization (WHO) and the American College of Obstetricians and Gynecologists.
There is evidence that delayed cord clamping has the following benefits for an infant:
Increases hemoglobin levels: the placental blood flow increases red blood cells that carry oxygen around the body.
Improves iron status: the extra iron boosts iron stores for the first six to eight months of the baby’s life.
Improves developmental outcomes: good iron levels are needed for psychomotor development, as iron deficiency can lead to impaired language skills, motor skills, and coordination.
Delayed blood clamping in HDFN-affected pregnancies
In pregnancies affected by HDFN, there is also potential for a positive impact of delayed cord clamping on the newborn. One study suggests that the extra red blood cells reduce the need for blood transfusion in the newborn and the influx of iron is beneficial when anemia is suspected or confirmed following birth. Close monitoring is advised.
It may not be an option for all HDFN-affected newborns, and its practice will be assessed according to the severity of symptoms, such as hydrops fetalis.
The only reported side effect to be considered is a possible higher risk of jaundice, which can be treated with phototherapy.
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