Guideline Video

Guideline Resources

  • Title: Postnatal Cord Blood Sampling
  • Society: American Academy of Pediatrics (AAP)
  • Publish Date: May 27, 2025
  • Guideline Summary
  • Full-text

Video Transcription

Just published May 27th, 2025 -The American Academy of Pediatric’s newest clinical report on Postnatal Cord Blood Sampling (PCBS). 

This report describes the evidence, safety, and methods for collecting cord blood after delivery.

There are 8 key action statements and 7 summary points, so let’s get started.

Starting with the key action statements,

  • For PCBS to produce optimal blood volumes, the umbilical cord must remain clamped after delayed cord clamping until PCBS is performed.
  • If there is a need for admission laboratory testing, PCBS should be used in all infants.
  • PCBS followed by research studies if needed and/or cord blood banking using the same or different phlebotomy sites can all be successful in most cases with discussion and planning prior to the delivery. In very low birth weight (VLBW) infants, PCBS should be prioritized over cord blood banking in most cases.
  • PCBS can be used to obtain a reliable CBC with differential.
  • Obtaining PCBS blood cultures, similar to other blood cultures, must be performed as an aseptic procedure.
  • PCBS can be used to obtain a reliable blood type, direct antiglobulin testing, and crossmatch.
  • PCBS can be used to obtain genetic studies.
  • PCBS can be used to obtain reliable coagulation studies

On to PCBS summary points: 

  1. PCBS collects neonatal blood and is a painless procedure that has been well studied and successful 95% of the time in obtaining admission laboratory studies.
  2. PCBS can be used to obtain a reliable blood culture, CBC with differential, blood type and crossmatch, genetic and metabolic testing, chemistries, and coagulation studies.
  3. If it is determined that blood tests are needed at or shortly after delivery, PCBS should be the first choice for phlebotomy and can be used in newborns of any gestational age in the first hour after birth.
  4. PCBS is most commonly performed for infants being admitted to the NICU, early-onset sepsis evaluations, initial and follow-up genetic testing, studies needed for infants with congenital anomalies, and deaths that occur prior to or shortly after delivery.
  5. For PCBS to be successful in obtaining optimal blood volumes for admission laboratory studies, after delayed cord clamping (or cord milking) the umbilical cord must remain clamped (can be quickly changed to a disposable clamp) until PCBS is performed.
  6. PCBS facilitates obtaining larger blood culture volumes potentially improving early-onset sepsis pathogen detection compared to infant phlebotomy, and similar to obtaining blood cultures from any site, must be performed as an aseptic procedure.
  7. PCBS for admission laboratory tests can be coordinated with research cord studies and cord blood banking. There may be deliveries where PCBS should be prioritized, for example in VLBW infants, where it prevents hypotension, the need for vasopressors, blood transfusions and potentially intraventricular hemorrhage. PCBS followed by research studies and/or cord blood banking using the same or different phlebotomy sites can all be successful in most cases with discussion and planning prior to the delivery.

Make sure to check out the full guideline from The American Academy of Pediatrics and other related clinical decision support tools at guidelinecentral.com

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