Background:

Delayed cord clamping (DCC) is increasingly recommended as a standard of care in term vaginal births due to its benefits. However, the optimal timing remains unclear. This randomized trial compares maternal and neonatal outcomes, as well as 6 month neurodevelopmental status, following physiological cord clamping versus cord clamping at 1 minute postpartum.

Methods:

We conducted a single-center randomized controlled trial between March 2021 and March 2023 at Nik Nafas Maternity Hospital in Rafsanjan, Iran. A total of 300 low-risk pregnant women undergoing spontaneous vaginal birth were randomized into two equal groups (n =150): (1) physiological cord clamping, and (2) cord clamping at 1 minute postpartum. Maternal and neonatal outcomes, infant feeding scores, and neurodevelopment at 6 months (Ages and Stages Questionnaire, ASQ) were assessed. Statistical analysis used SPSS 22 with chi square, independent t test, and Mann–Whitney U tests; significance was set at p < 0.05.

Results:

There were no significant differences between groups in 1 and 5 minute Apgar scores, neonatal heart rate or respiratory rate at 10 minutes, duration of the third stage of labor, excessive postpartum bleeding, breastfeeding success score, neonatal jaundice or phototherapy requirement, or ASQ developmental status at 6 months (all p > 0.05).

Conclusions:

Both physiological cord clamping and cord clamping at 1 minute postpartum are safe and effective in low risk term deliveries, with no significant impact on maternal or neonatal morbidity or early neurodevelopment. These findings support flexibility in DCC