Postnatal Cord Blood Sampling: Clinical Report

Blood contained in the umbilical cord after placental separation originates from the infant and can be used for neonatal blood sampling and testing after birth. The most common indications for phlebotomy after birth include care processes for any infant admitted to the neonatal intensive care unit, early-onset sepsis evaluations, and congenital anomalies. Postnatal umbilical cord blood sampling (PCBS), rather than obtaining blood from the neonate, avoids significant neonatal blood loss at a critical time of extrauterine transition and prevents phlebotomy pain in infants without a catheter for blood drawing. Studies of PCBS in very low birth weight infants have demonstrated additional benefits including stable blood pressure, less need for vasopressors and erythrocyte transfusions in the first week, and a potentially decreased risk for intracranial hemorrhage. PCBS can be used for any full-term or preterm infant when the need for phlebotomy is known at or shorty after delivery. PCBS can be the first option and reliably used for complete blood cell counts, blood cultures, blood typing and crossmatching, newborn screening and metabolic tests, genetic testing, blood chemistries, and coagulation studies. Additionally, PCBS allows the collection of larger blood volumes for blood culture, thereby improving positivity rate. Finally, PCBS can be performed after delayed cord clamping or cord milking and in conjunction with research studies and/or cord blood banking. This report describes the evidence, safety, and methods for collecting cord blood after delivery.