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OBJECTIVE	Prevention of iron deficiency in infancy may promote neurodevelopment .
OBJECTIVE	Delayed cord clamping ( DCC ) can prevent iron deficiency during the first 6 months of life .
OBJECTIVE	However , no data are available on long-term effects on infant outcomes in relation to time for umbilical cord clamping .
OBJECTIVE	To investigate effects of DCC , as compared with early cord clamping ( ECC ) , on infant iron status and neurodevelopment at age 12 months in a European setting .
METHODS	Randomized clinical trial of 382 full-term infants born after a low-risk pregnancy at a Swedish county hospital .
METHODS	Follow-up at 12 months included evaluation of iron status ( ferritin level , transferrin saturation , transferrin receptor level , reticulocyte hemoglobin level , and mean cell volume ) and parental assessment of neurodevelopment by the Ages and Stages Questionnaire , second edition ( ASQ ) .
METHODS	Infants were randomized to DCC ( 180 seconds after delivery ) or ECC ( 10 seconds after delivery ) .
METHODS	The main outcome was iron status at age 12 months ; the secondary outcome was ASQ score .
RESULTS	In total , 347 of 382 infants ( 90.8 % ) were assessed .
RESULTS	The DCC and ECC groups did not differ in iron status ( mean ferritin level , 35.4 vs 33.6 ng/mL , respectively ; P = .40 ) or neurodevelopment ( mean ASQ total score , 229.6 vs 233.1 , respectively ; P = .42 ) at age 12 months .
RESULTS	Predictors of ferritin levels were infant sex and ferritin in umbilical cord blood .
RESULTS	Predictors of ASQ score were infant sex and breastfeeding within 1 hour after birth .
RESULTS	For both outcomes , being a boy was associated with lower results .
RESULTS	Interaction analysis showed that DCC was associated with an ASQ score 5 points higher among boys ( mean [ SD ] score , 229 [ 43 ] for DCC vs 224 [ 39 ] for ECC ) but 12 points lower among girls ( mean [ SD ] score , 230 [ 39 ] for DCC vs 242 [ 36 ] for ECC ) , out of a maximum of 300 points ( P = .04 for the interaction term ) .
CONCLUSIONS	Delayed cord clamping did not affect iron status or neurodevelopment at age 12 months in a selected population of healthy term-born infants .
CONCLUSIONS	However , it may not be possible to demonstrate minor effects on neurodevelopment with the size of the study population and the chosen method for assessment .
CONCLUSIONS	The current data indicate that sex may influence the effects on infant development after DCC in different directions .
CONCLUSIONS	The magnitude and biological reason for this finding remain to be investigated .
CONCLUSIONS	TRIAL REGISTRATION clinicaltrials.gov Identifier : NCT01245296 .

