***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Iron deficiency anemia is a serious health problem that affects the physical and cognitive development of children . Therefore , it is important to develop cost-effective interventions to improve the hematologic status of the millions of children affected by this condition worldwide . We studied 69 Guatemalan infants who had been r and omly assigned to one of three groups at the time of delivery : 1 ) cord clamping immediately after delivery ( n = 21 ) ; 2 ) clamping when the cord stopped pulsating , with the infant placed at the level of the placenta ( n = 26 ) ; or 3 ) clamping when the cord stopped pulsating , with the newborn placed below the level of the placenta ( n = 22 ) . Maternal and infant hematologic assessment s were performed at the time of delivery and 2 mo postpartum . At baseline the groups had similar socioeconomic , demographic , and biomedical characteristics and the newborns had similar hematocrit status . Two months after delivery , infants in the two groups with delayed cord clamping had significantly higher hematocrit values and hemoglobin concentrations than did those in the early-clamping group . The percentage with hematocrit values < 0.33 was 88 % in the control group compared with 42 % in group 2 and 55 % in group 3 ( P = 0.01 ) . These results suggest that waiting until the umbilical cord stops pulsating ( approximately 1 min after delivery ) is a feasible low-cost intervention that can reduce anemia in infants in developing countries OBJECTIVE : This pilot study 's aim was to establish feasibility of a protocol for delayed cord clamping ( DCC ) versus immediate cord clamping ( ICC ) at preterm birth and to examine its effects on initial blood pressure and other outcomes . STUDY DESIGN : A r and omized controlled trial recruited 32 infants between 24 and 32 weeks . Immediately before delivery , mothers were r and omized to ICC ( cord clamped at 5 to 10 seconds ) or DCC ( 30- to 45-second delay in cord clamping ) groups . RESULTS : Intention-to-treat analyses revealed that the DCC group were more likely to have higher initial mean blood pressures ( adjusted OR 3.4 ) and less likely to be discharged on oxygen ( adjusted OR 8.6 ) . DCC group infants had higher initial glucose levels ( ICC=36 mg/dl , DCC=73.1 mg/dl ; p=0.02 ) . CONCLUSION : The research design is feasible . The immediate benefit of improved blood pressure was confirmed and other findings deserve consideration for further study Abstract This study was carried out to assess the feasibility of late cord clamping of 45 s in preterm infants delivered mainly by caesarean section and the effects on post-partal adaptation and anaemia of prematurity . Prior to delivery , 40 infants of <33 gestational weeks were r and omised to either 20 s or 45 s of late cord clamping . After the first shoulder was delivered , oxytocin was given intravenously to the mother in order to enhance placento-fetal transfusion while the infant was held below the level of the placenta . The 20 infants in group 1 ( 20 s ) had a mean birth weight of 1070 g and a mean gestational age of 29 + 4/7 weeks versus 1190 g and 30 weeks in group 2 ( 45 s ) . On day 42 of life there were ten infants without transfusions in group 2 versus three in group 1 ( P < 0.05 ) . Out of the 20 infants in group 1 , 19 and 15/19 in group 2 were delivered by caesarean section . There were no significant differences in Apgar scores , temperature on admission , heart rate , blood pressure and requirements for artificial ventilation . Conclusion Delayed cord clamping of 45 s is feasible and safe in preterm infants below 33 weeks of gestation . It is possible to perform the procedure at caesarean section deliveries and it should be performed whenever possible . It reduces the need for packed red cell transfusions during the first 6 weeks of life OBJECTIVE . This study compared the effects of immediate ( ICC ) and delayed ( DCC ) cord clamping on very low birth weight ( VLBW ) infants on 2 primary variables : bronchopulmonary dysplasia ( BPD ) and suspected necrotizing enterocolitis ( SNEC ) . Other outcome variables were late-onset sepsis ( LOS ) and intraventricular hemorrhage ( IVH ) . STUDY DESIGN . This was a r and omized , controlled unmasked trial in which women in labor with singleton fetuses < 32 weeks ’ gestation were r and omly assigned to ICC ( cord clamped at 5–10 seconds ) or DCC ( 30–45 seconds ) groups . Women were excluded for the following reasons : their obstetrician refused to participate , major congenital anomalies , multiple gestations , intent to withhold care , severe maternal illnesses , placenta abruption or previa , or rapid delivery after admission . RESULTS . Seventy-two mother/infant pairs were r and omized . Infants in the ICC and DCC groups weighed 1151 and 1175 g , and mean gestational ages were 28.2 and 28.3 weeks , respectively . Analyses revealed no difference in maternal and infant demographic , clinical , and safety variables . There were no differences in the incidence of our primary outcomes ( BPD and suspected NEC ) . However , significant differences were found between the ICC and DCC groups in the rates of IVH and LOS . Two of the 23 male infants in the  DCC group had IVH versus 8 of the 19 in the ICC group . No cases of sepsis occurred in the 23 boys in the DCC group , whereas 6 of the 19 boys in the ICC group had confirmed sepsis . There was a trend toward higher initial hematocrit in the infants in the DCC group . CONCLUSIONS . Delayed cord clamping seems to protect VLBW infants from IVH and LOS , especially for male infants This study was conducted to evaluate the haematological effects of the timing of umbilical cord clamping in term infants 24 h after birth in Libya . Mother-infant pairs were r and omly assigned to early cord clamping ( within 10 s after delivery ) or delayed clamping ( after the cord stopped pulsating ) . Maternal haematological status was assessed on admission in the delivery room . Infant haematological status was evaluated in cord blood and 24 h after birth . Bilirubin concentration was assessed at 24 h. 104 mother-infant pairs were r and omized to delayed ( n=58 ) or early cord clamping ( n=46 ) . At baseline the groups had similar demographic and biomedical characteristics , except for a difference in maternal haemoglobin , which was significantly higher in the early clamping group ( 11.7 g/dL , SD 1.3 g/dL versus 10.9 g/dL , SD 1.6 g/dL ; P=0.0035 ) . Twenty-four hours after delivery the mean infant haemoglobin level was significantly higher in the delayed clamping group ( 18.5 g/dL versus 17.1 g/dL ; P=0.0005 ) . No significant differences were found in clinical jaundice or plethora . Surprisingly , blood analysis showed that two babies in the early clamping group had total serum bilirubin levels ( > 15 mg/dL ) that necessitated phototherapy . There were no babies in the late clamping group who required phototherapy . Three infants in the delayed clamping group had polycythaemia without symptoms , for which no partial exchange transfusion was necessary . Delaying cord clamping until the pulsations stop increases the red cell mass in term infants . It is a safe , simple and low cost delivery procedure that should be incorporated in integrated programmes aim ed at reducing iron deficiency anaemia in infants in developing countries BACKGROUND Delayed clamping of the umbilical cord increases the infant 's iron endowment at birth and haemoglobin concentration at 2 months of age . We aim ed to assess whether a 2-minute delay in the clamping of the umbilical cord of normal-weight , full-term infants improved iron and haematological status up to 6 months of age . METHODS 476 mother-infant pairs were recruited at a large obstetrics hospital in Mexico City , Mexico , r and omly assigned to delayed clamping ( 2 min after delivery of the infant 's shoulders ) or early clamping ( around 10 s after delivery ) , and followed up until 6 months postpartum . Primary outcomes were infant haematological status and iron status at 6 months of age , and analysis was by intention-to-treat . This study is registered with Clinical Trials.gov , number NCT00298051 . FINDINGS 358 ( 75 % ) mother-infant pairs completed the trial . At 6 months of age , infants who had delayed clamping had significantly higher mean corpuscular volume ( 81.0 fL vs 79.5 fL 95 % CI -2.5 to -0.6 , p=0.001 ) , ferritin ( 50.7 mug/L vs 34.4 mug/L 95 % CI -30.7 to -1.9 , p=0.0002 ) , and total body iron . The effect of delayed clamping was significantly greater for infants born to mothers with low ferritin at delivery , breastfed infants not receiving iron-fortified milk or formula , and infants born with birthweight between 2500 g and 3000 g. A cord clamping delay of 2 minutes increased 6-month iron stores by about 27 - 47 mg . INTERPRETATION Delay in cord clamping of 2 minutes could help prevent iron deficiency from developing before 6 months of age , when iron-fortified complementary foods could be introduced The Leboyer birth method requires that the newly born infant is placed on the mother 's abdomen and the cord is clamped when it stops pulsating . This investigation was done to study the effect of Leboyer childbirth on neonatal circulation during the first 5 days after birth . Hematocrit , blood viscosity , left and right ventricular output , and cerebral blood flow velocities in the arteria carotis interna , arteria cerebri anterior , and truncus coeliacus were studied in 15 full-term neonates with early ( less than 10 seconds ) cord clamping and 15 full-term neonates delivered according to Leboyer ( cord clamping after 3 minutes ) on day 1 ( 2 to 4 hours after birth ) and day 5 . The fetal placental blood volume decreased from 42 + /- 8 mL/kg ( mean + /- SD ) of neonatal body weight after early cord clamping to 19 + /- 7 mL/kg after Leboyer delivery . Neonatal blood volume , calculated from the fetal placental blood volume , was 32 % higher in the Leboyer group compared with the early cord-clamped infants . In the infants with early cord clamping , hematocrit , and blood viscosity did not change significantly during the first 5 days . After Leboyer birth , the hematocrit rose from 0.51 + /- 0.05 in cord blood to 0.62 + /- 0.06 at 2 to 4 hours of age , thereby increasing blood viscosity by 32 % . Stroke volume , heart rate , cardiac output , left-to-right shunt across the ductus arteriosus , and blood flow velocity in the truncus coeliacus were similar in both groups and did not change during the first 5 days . ( ABSTRACT TRUNCATED AT 250 WORDS The Leboyer birth method requires that the newborn infant is placed on the mothers abdomen and the cord is clamped when it stops pulsating . Since late cord-clamping may result in marked hypervolemia and polycythemia of the neonate , we studied right and left ventricular systolic time intervals by means of pulsed-Doppler echocardiography . Left and right ventricular preejection periods ( LPEP , RPEP ) , right time peak velocity ( RTPV ) , left and right ventricular ejection times ( LVET , RVET ) , and ratio of RTPV/RVET(c ) corrected for heart rate were studied in 15 fullterm neonates with early ( < 10s ) cord clamping and in 15 fullterm neonates delivered according to Leboyer ( cord clamping after 3 min ) on day 1 ( 2 - 4 h after birth ) and day 5 . After Leboyer birth hematocrit was significantly increased on day 1 ( 0.61 + /- 0.06 vs. 0.53 + /- 0.07 ) and on day 5 ( 0.57 + /- 0.02 vs. 0.50 + /- 0.07 ) . Blood pressure was similar in both groups and increased by about 10 % from day 1 to day 5 . LVET and RVET were not affected by the mode of placental transfusion , thereby suggesting normal left and right ventricular function after Leboyer birth . The LPEP/LVET ( 0.36 + /- 0.09 vs. 0.30 + /- 0.08 ) and RPEP/RVET ratio ( 0.41 + /- 0.11 vs. 0.33 + /- 0.08 ) were significantly higher in the Leboyer group ( p < 0.05 ) compared to the early cord clamped group suggesting higher systemic and pulmonary resistance . RPEP decreased significantly by 17 % in the control group from day 1 to day 5 ( p < 0.05 ) , but did not change in 
    Output:
    
Delaying clamping of the umbilical cord in full-term neonates for a minimum of 2 minutes following birth is beneficial to the newborn , extending into infancy .
Although there was an increase in polycythemia among infants in whom cord clamping was delayed , this condition appeared to be benign