Supporting the neonatal transition at preterm birth: optimising the time of umbilical cord clamping and maternal interventions

The transition from fetal to neonatal circulation is a period of cardiovascular instability in preterm infants. Delayed cord clamping has been proposed to support this transition. While traditionally thought to benefit the infant through a placental transfusion, recent evidence highlights the importance of establishing respiration before clamping—termed physiological-based cord clamping. This approach promotes greater cardiovascular stability. This thesis investigates the underlying mechanisms of benefit of delayed cord clamping, as well as examines the influence of events that occur at the time of birth, including maternal oxytocin administration and oxygen supplementation, during this critical phase to improve outcomes of preterm infants.