Delayed Cord Clamping Techniques for Newborns with Congenital Heart Disease

(CORD-CHD Trial)

This trial explores the optimal timing for clamping the umbilical cord in newborns with congenital heart disease, a condition affecting the heart's structure from birth. It compares clamping at 30 seconds versus 120 seconds after birth to determine which timing leads to better health and movement outcomes for babies. Parents expecting to deliver a single baby between 37 and 42 weeks, who have been informed of their unborn child's congenital heart disease, might be suitable candidates. Participants will be randomly assigned to one of the two timing groups and will undergo follow-up assessments to track development. As an unphased trial, this study provides a unique opportunity to contribute to important research that could improve outcomes for future newborns with congenital heart disease.

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your healthcare provider.

Research has shown that waiting before cutting the umbilical cord, known as delayed cord clamping, is generally safe for newborns, even those with congenital heart conditions. Studies have found that babies whose cords are clamped about two minutes after birth often require fewer blood transfusions, indicating safety.

Researchers are excited about investigating delayed cord clamping techniques for newborns with congenital heart disease because these methods might improve early health outcomes. Unlike immediate cord clamping, which is typically done within seconds after birth, delayed clamping allows more time for blood from the placenta to transfer to the newborn, potentially increasing blood volume and improving oxygen levels. The trial explores two different timings: clamping at around 30 seconds and at around 120 seconds, as well as a technique called umbilical cord milking, which involves gently pushing blood toward the baby. These approaches could offer a simple, low-cost way to enhance early heart function and overall stability in these vulnerable newborns.

Research has shown that waiting before clamping the umbilical cord can benefit newborns, especially those with congenital heart disease (CHD). This trial will assign participants to different arms to test the effects of delayed cord clamping. One arm will delay clamping for about 30 seconds, while another will delay for about 120 seconds. Studies have found that delaying cord clamping for 30 to 120 seconds can improve hemoglobin levels, aiding oxygen delivery throughout the body, and reduce the need for blood transfusions. Although there is some discussion about the optimal timing, both methods have been linked to positive outcomes for babies. Even a short delay in clamping the cord can provide these health benefits.¹³⁴⁶⁷