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Am J Perinatol
DOI: 10.1055/a-2744-8299
Original Article

Maternal, Obstetric, and Neonatal Characteristics Associated with Delayed Cord Clamping

Authors

  • Emily Zhao 

    1   Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, United States (Ringgold ID: RIN1500)

  • Breanna Valcarcel

    2   Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, United States (Ringgold ID: RIN1466)

  • Camille Shantz

    3   Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, United States (Ringgold ID: RIN1466)

  • Lauren Meiss

    2   Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, United States (Ringgold ID: RIN1466)

  • Siwei Xie

    4   Johns Hopkins Bloomberg School of Public Health, Baltimore, United States (Ringgold ID: RIN25802)

  • Sean Tackett

    5   Johns Hopkins University, Baltimore, United States (Ringgold ID: RIN1466)

  • Brittany Schwarz

    6   Division of Neonatal-Perinatal Medicine, Johns Hopkins University, Baltimore, United States (Ringgold ID: RIN1466)

  • Mara Rosner

    3   Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, United States (Ringgold ID: RIN1466)
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Objective To evaluate the factors associated with completed delayed cord clamping (DCC). Study Design We conducted a retrospective review of viable singleton deliveries at a single academic medical center from January 1, 2020-Dec 31, 2022. Demographics, obstetric variables, and neonatal data were extracted from the electronic medical record. Patients who received DCC were compared to those who did not. Multivariate logistic regression was used to assess factors associated with completion of 30-60 seconds of DCC, with a sub-analysis of preterm deliveries < 30 weeks. Results DCC was completed in 5018/5889 (85.2%) eligible deliveries. Lower DCC rates were observed among non Black, White, or Asian patients vs White patients (82.1% vs 87.1%; adjusted odds ratio [aOR] 0.60, 95% CI 0.47-0.78) and in 2020 vs 2022 (83.6% vs 86.5%; aOR 0.74, 95% CI 0.61-0.91). Patients who completed DCC had lower mean BMI (32.59 vs 34.53, aOR 0.99, 95% CI 0.98-0.996), were less likely to be nulliparous (83.9% vs 86.4%, aOR 0.78, 95% CI 0.66-0.92), less likely to have pregestational diabetes (72.8% vs 86.1%, aOR 0.63, 95% CI 0.45-0.87), chorioamnionitis (72.9% vs 85.6%, aOR 0.51, 95% CI 0.36-0.73), or postpartum hemorrhage (73.0% vs 85.6%, aOR 0.59, 95% CI 0.41-0.86). Preterm (68.5% vs 87.8%, aOR 0.50, 95% CI 0.40-0.63) and cesarean deliveries (77.2% vs 90.0%, aOR 0.72, 95% CI 0.60-0.85), and infants requiring resuscitation (61.7% vs 91.6%; aOR 0.20, 95% CI 0.17-0.23) were less likely to have completed DCC. Among preterm newborns < 30 weeks, neonatal resuscitation was the only factor associated with not receiving DCC after adjustment. Conclusion Race, delivery mode and year, maternal BMI, nulliparity, pregestational diabetes, chorioamnionitis, postpartum hemorrhage, preterm birth, and neonatal resuscitation were independently associated with completed DCC. Strategies to improve DCC execution should target preterm infants and address the challenges of performing DCC in neonates requiring urgent resuscitation.



Publication History

Received: 04 June 2025

Accepted after revision: 12 November 2025

Accepted Manuscript online:
12 November 2025

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