Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes

Heike Rabe; Gillian ML Gyte; José L Díaz‐Rossello; Lelia Duley

doi:10.1002/14651858.CD003248.pub4

Cochrane Database of Systematic Reviews

Efecto del momento adecuado para el pinzamiento del cordón umbilical y otras estrategias para influir en la transfusión placentaria durante el parto prematuro en los resultados maternos y del lactante

Información

DOI:

https://doi.org/10.1002/14651858.CD003248.pub4 Copiar DOI

Base de datos:

Cochrane Database of Systematic Reviews

Versión publicada:

17 septiembre 2019see what's new

Tipo:

Intervention

Etapa:

Review

Grupo Editorial Cochrane:

Grupo Cochrane de Embarazo y parto

Copyright:

Copyright © 2019 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Contraer

Autores

Heike Rabe

Correspondencia a: BSMS Academic Department of Paediatrics, Brighton and Sussex University Hospitals, Royal Sussex Country Hospital, Brighton, UK

[email protected]

[email protected]
Gillian ML Gyte

Cochrane Pregnancy and Childbirth Group, Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
José L Díaz‐Rossello

Departamento de Neonatologia del Hospital de Clínicas, Montevideo, Uruguay
Lelia Duley

Nottingham Clinical Trials Unit, Nottingham Health Science Partners, Nottingham, UK

Contributions of authors

For this update

Gill Gyte (GG) undertook the data extraction and data entry with assistance from Heike Rabe (HR), Jose Diaz‐Rosello (JDR) and Lelia Duley (LD). HR, JDR and LD contributed clinical knowledge and input. GG conducted the GRADE assessments and drafted the results section. Review authors assessed the studies independently. HR and LD did not assess their own studies and GG did not assess the study on which she was a co‐applicant.

For previous versions of the review

Graham Reynolds (GR) prepared the first draft of the protocol and commented on the second draft. HR commented on the first draft of the protocol and wrote the second draft.

All review authors assessed studies independently. HR did not assess her own study. HR and GR entered study data. GR wrote the 'Methodological quality of included studies' section. HR completed all other sections of the review. JDR completed the corrections to the statistics. All three review authors commented on the review and agreed on the conclusion.

For the update of this review, the process of assessing the eligible studies and extracting the data were followed in the same way as described as above. HR updated the data tables and updated the text of the review. JDR and Therese Dowswell (TD) corrected the statistics. TD and LD introduced the risk of bias tables, and revised the text of the review. All review authors agreed on the updated version of the review.

Sources of support

Internal sources

University of Liverpool, UK.

External sources

No sources of support, UK.

Declarations of interest

Heike Rabe is main author for two included studies in this review (Rabe 2000; Rabe 2011). Studies by the contact author, which may be relevant for inclusion in this review, were not assessed by herself but by the co‐authors who, in agreement with the Cochrane Pregnancy and Childbirth group, have named other experts in the field for this purpose.

Jose Diaz‐Rossello ‐ none known.

Lelia Duley has been awarded an NIHR research grant for a programme of work which includes a pilot trial of timing of cord clamping for preterm births (CORD Pilot 2018), and a prospective meta‐analysis.

Gillian Gyte was a co‐applicant on one of the included studies in this review (CORD Pilot 2018). She also has received royalties from John Wiley & Son in respect of ‘A Cochrane Pocket Handbook – Pregnancy and Childbirth' Hofmeyr GJ et al. 2008.

Acknowledgements

Diane Elbourne who undertook the first Cohrane Review on this topic (Elbourne 1995).

Therese Dowswell who provided considerable input into the 2012 publication (Rabe 2012).

Graham Reynolds for his editorial and clinical contributions to previous versions of this review.

W Oh, M McDonnell, M Nelle, S Kinmond, J Mercer, N Aladangady A Katheria and H Rabe who kindly provided additional information regarding their studies. The information about randomisation for the trials by W Oh and M Nelle was directly obtained from the authors. The review authors thank the authors for supplying the information.

Jon Dorling, Donna Winterbank‐Scott, Lambert Felix, Anna Cuthbert all provided help with data extraction of information from the studies. Aidan Tan provided very helpful translations of the three Chinese papers.

As part of the pre‐publication editorial process, this review has been commented on by five peers (an editor and four referees who are external to the editorial team) and the Group's Statistical Adviser. The authors are grateful to the following peer reviewers for their time and comments: Prof NJ Shaw, Liverpool Women's Hospital; Andrew D Weeks, University of Liverpool; Jamie B Warren MD MPH, Oregon Health & Science University; Serena Xodo MD, Clinic of Obstetrics and Gynecology, Academic Hospital of Udine, Udine (Italy).

This project was supported by the National Institute for Health Research, via Cochrane Infrastructure funding to Cochrane Pregnancy and Childbirth. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, NHS or the Department of Health.

Version history

Published

Title

Stage

Authors

Version

2019 Sep 17

Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes

Review

Heike Rabe, Gillian ML Gyte, José L Díaz‐Rossello, Lelia Duley

https://doi.org/10.1002/14651858.CD003248.pub4

Event

Description

2017 Nov 10

New citation required and conclusions have changed

We updated the search (November 2017) and included 33 new studies. The data now show that compared with early cord clamping, delayed cord clamping probably reduces the risk of infant death before hospital discharge.

2017 Nov 10

New search has been performed

Gillian Gyte has joined the team.

We have separated delayed cord clamping from umbilical cord milking and included a new delayed intervention where immediate neonatal care is given with the cord intact.

We have re‐visited the outcomes and modified them to focus more on clinical outcomes (See Differences between protocol and review).

New subgroups are gestation and type of intervention (see Differences between protocol and review).

We have extended the definition of 'low risk' for sensitivity analyses to include sequence generation, allocation concealment and incomplete outcome data.

We have restructured the 'Plain language summary' to incorporate standardised headings.

Four new 'Summary of findings' tables have been incorporated.

We updated the search in November 2018 and identified 26 new reports. The references have been assessed but not fully incorporated into the review. Two of these were additional reports of included studies with no new data so the references have been added under the main study (Katheria 2015; Tarnow‐Mordi 2017). Six are new studies to be fully assessed at the next update (Kazemi 2017; Leal 2018; Li 2018; Ram Mothan 2018; Song 2017; Weeks 2018). Three are additional reports of included studies and the new data will be added at the next update (Das 2018a; El‐Naggar 2018; Wang 2018). The remaining 15 reports refer to 11 ongoing studies and have been added to Ongoing studies (Aghai 2018; Allam 2018; Gupta 2018; Hao 2018; Jomjak 2018; Katheria 2018; Liu 2018; Mirzaeian 2018; Nour 2018a; Nour 2018b; Shahgheibi 2018).

2012 Aug 15

Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes

Review

Heike Rabe, Jose Luis Diaz‐Rossello, Lelia Duley, Therese Dowswell

https://doi.org/10.1002/14651858.CD003248.pub3

2004 Oct 18

Early versus delayed umbilical cord clamping in preterm infants

Review

Heike Rabe, Graham J Reynolds, Jose Luis Diaz‐Rosello

https://doi.org/10.1002/14651858.CD003248.pub2

2001 Jul 23

Delayed cord clamping in preterm infants

Protocol

Heike Rabe, Graham J Reynolds

https://doi.org/10.1002/14651858.CD003248

Differences between protocol and review

We set up separate comparisons for delayed cord clamping and umbilical cord milking.

HR, LD and GG modified the list of outcomes choosing seven primary outcomes to assist the assessment using GRADE software.

We removed the following outcomes: Requirement for resuscitation; Apgar scores at 1,5 and 10 minutes; Use of exogenous surfactant; Days of oxygen dependency; Oxygen dependency at 28 days; Treatment for hyperbilirubinaemia with blood exchange transfusion; Blood counts at six and 12 months of age (haemoglobin and ferritin); Maternal death.

We added the following new outcomes: Apgar < eight at five minutes: Duration of respiratory support; Home oxygen; Mean arterial blood pressure in early hours after birth; Hydrocephalis; Neurosensory disability at two to three years; Cerebral Palsy; Late sepsis; Treatment for retinopathy of prematurity; Severe visual impairment; Length of infant stay in NICU; Maternal blood transfusion; Maternal postpartum infection; Breastfeeding initiation; Fully breastfeeding or mixed breast & formula feeding at discharge.

We changed the following outcomes: 'Maternal blood loss greater than 500 mL' to 'Maternal blood loss of 500 mL or greater'; ‘Hypothermia’ to ‘Temperature < 36^o within 1 hour of birth’; ‘Oxygen dependency at 36 weeks to CLD with this definition; Chronic lung disease (Northway Stage two, three or four) to CLD (oxygen dependency at 36 weeks corrected for gestational age)’; ‘Volume (colloid, sodium chloride 0.9%, blood transfusion) administration for hypotension during the first 24 hours of life’ to ‘Blood transfusion in infant’; 'Maternal bonding to infant' to 'Bonding'

Due to lack of data for previously intended subgroups (Position of the baby relative to the placenta; Whether the mother had oxytocin before cord clamping; With or without milking of the cord; Mode of birth), we chose to look at gestation and type of intervention only.

We updated the methods including the use of GRADE as recommended by Cochrane's MECIR standards and incorporated four new 'Summary of findings' tables.

We updated the Plain language summary to reflect the Cochrane Pregnancy and Childbirth Group's guidance on this.

We searched ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) for unpublished, planned and ongoing trial reports.

Notes

The title of the previously published protocol was 'Early versus delayed cord clamping in preterm infants'.

Keywords

MeSH

Medical Subject Headings (MeSH) Keywords

Medical Subject Headings Check Words

Female; Humans; Infant, Newborn; Pregnancy;

PICO

Population

Intervention

Comparison

Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Figure 1

Study flow diagram.

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Figure 2

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Figure 3

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

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Figure 4

Funnel plot of comparison: 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), outcome: 1.1 Death of baby (up to discharge).

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Figure 5

Funnel plot of comparison: 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), outcome: 1.3 Severe intraventricular haemorrhage (IVH grades 3, 4).

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Figure 6

Funnel plot of comparison: 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), outcome: 1.4 Intraventricular haemorrhage (IVH, all grades).

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Analysis 1.1

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 1 Death of baby (up to discharge).

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Analysis 1.3

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 3 Severe intraventricular haemorrhage (IVH grades 3, 4).

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Analysis 1.4

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 4 Intraventricular haemorrhage (IVH, all grades).

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Analysis 1.5

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 5 Periventricular leukomalacia (PVL).

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Analysis 1.6

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation).

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Analysis 1.7

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 7 Maternal blood loss of 500 mL or greater.

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Analysis 1.8

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 8 Intraventricular haemorrhage (IVH, grades 1 & 2).

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Analysis 1.9

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 9 Necrotising enterocolitis (NEC) confirmed by X‐ray or laparotomy).

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Analysis 1.10

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 10 Respiratory Distress Syndrome (RDS).

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Analysis 1.11

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 11 Respiratory support (ventilator or CPAP).

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Analysis 1.12

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 12 Duration of respiratory support (in days).

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Analysis 1.13

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 13 Surfactant treatment (for severe RDS).

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Analysis 1.14

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 14 Treatment for Patent Ductus Arteriosus (PDA) (medical and/or surgical).

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Analysis 1.15

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 15 Treatment for Retinopathy of Prematurity (RoP).

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Analysis 1.16

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 16 Hyperbilirubinemia (treated by phototherapy).

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Analysis 1.17

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 17 Inotropics for low blood pressure.

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Analysis 1.18

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 18 Low Apgar as defined by trialists (generally < 8 at 5 mins).

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Analysis 1.19

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 19 Blood transfusion in infant.

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Analysis 1.20

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 20 Volume of blood transfused (mL).

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Analysis 1.21

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 21 Late sepsis (after 3 days or as defined by trialists).

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Analysis 1.23

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 23 Temperature < 36.0^oC within 1 hour of birth.

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Analysis 1.24

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 24 Hb within 1^st 24 hour of birth (g/dL).

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Analysis 1.25

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 25 Mean arterial blood pressure in early hours after birth (mm Hg).

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Analysis 1.27

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 27 Home oxygen.

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Analysis 1.33

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 33 Blood transfusion for mother.

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Analysis 1.39

Comparison 1 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation), Outcome 39 Fully breastfed or mixed feeding at infant discharge.

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Analysis 2.1

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 1 Death of baby (up to discharge).

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Analysis 2.3

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 3 Severe intraventricular haemorrhage (IVH grades 3, 4).

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Analysis 2.4

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 4 Intraventricular haemorrhage (IVH, all grades).

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Analysis 2.5

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 5 Periventricular leukomalacia (PVL).

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Analysis 2.6

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation).

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Analysis 2.7

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 7 Maternal blood loss of 500 mL or greater.

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Analysis 2.8

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 8 Intraventricular haemorrhage (IVH, grades 1 & 2).

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Analysis 2.9

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 9 Necrotising enterocolitis (NEC) confirmed by X‐ray or laparotomy).

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Analysis 2.10

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 10 Respiratory Distress Syndrome (RDS).

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Analysis 2.11

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 11 Respiratory support (ventilator or CPAP).

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Analysis 2.12

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 12 Duration of respiratory support.

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Analysis 2.13

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 13 Surfactant treatment (for severe RDS).

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Analysis 2.14

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 14 Treatment for Patent Ductus Arteriosus (PDA) (medical and/or surgical).

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Analysis 2.15

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 15 Treatment for Retinopathy of Prematurity (RoP).

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Analysis 2.16

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 16 Hyperbilirubinemia (treated by phototherapy).

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Analysis 2.17

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 17 Inotropics for low blood pressure.

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Analysis 2.18

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 18 Low Apgar as defined by trialists (generally < 8 at 5 mins).

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Analysis 2.19

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 19 Blood transfusion in infant.

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Analysis 2.20

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 20 Volume of blood transfused (mL).

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Analysis 2.21

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 21 Late sepsis (after 3 days or as defined by trialists).

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Analysis 2.23

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 23 Temperature < 36.0^oC within 1 hour of birth.

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Analysis 2.24

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 24 Hb within 1^st 24 hour of birth (g/dL).

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Analysis 2.25

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 25 Mean arterial blood pressure in early hours after birth (mm Hg).

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Analysis 2.27

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 27 Home oxygen.

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Analysis 2.33

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 33 Blood transfusion for mother.

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Analysis 2.39

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 39 Fully breastfed or mixed feeding at infant discharge.

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Analysis 2.42

Comparison 2 DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention), Outcome 42 Neurosensory disability at 7 months (Bailey's MDI < 70) ‐ not prespecified.

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Analysis 3.1

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 1 Death of baby (up to discharge).

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Analysis 3.2

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 2 Death or neurodevelopmental impairment at age two to three years.

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Analysis 3.3

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 3 Severe intraventricular haemorrhage (IVH grades 3, 4).

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Analysis 3.4

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 4 Intraventricular haemorrhage (IVH, all grades).

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Analysis 3.5

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 5 Periventricular leukomalacia (PVL).

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Analysis 3.6

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation).

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Analysis 3.7

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 7 Maternal blood loss of 500 mL or greater.

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Analysis 3.8

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 8 Intraventricular haemorrhage (IVH, grades 1 & 2).

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Analysis 3.9

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 9 Necrotising enterocolitis (NEC) confirmed by X‐ray or laparotomy).

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Analysis 3.11

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 11 Respiratory support (ventilator or CPAP).

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Analysis 3.14

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 14 Treatment for Patent Ductus Arteriosus (PDA) (medical and/or surgical).

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Analysis 3.15

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 15 Treatment for Retinopathy of Prematurity (RoP).

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Analysis 3.16

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 16 Hyperbilirubinemia (treated by phototherapy).

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Analysis 3.19

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 19 Blood transfusion in infant.

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Analysis 3.21

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 21 Late sepsis (after 3 days or as defined by trialists).

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Analysis 3.22

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 22 Hydrocephalus.

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Analysis 3.23

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 23 Temperature < 36.0^oC within 1 hour of birth.

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Analysis 3.28

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 28 Neurodevelopmental impairment at age two to three years.

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Analysis 3.31

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 31 Manual removal of placenta (denominator = vaginal births).

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Analysis 3.32

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 32 Prolonged third stage (>30 minutes) (denominator = vaginal births).

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Analysis 3.33

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 33 Blood transfusion for mother.

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Analysis 3.34

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 34 Postpartum infection in mother.

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Analysis 3.39

Comparison 3 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation), Outcome 39 Fully breastfed or mixed feeding at infant discharge.

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Analysis 4.1

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 1 Death of baby (up to discharge).

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Analysis 4.2

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 2 Death or neurodevelopmental impairment at age two to three years.

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Analysis 4.3

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 3 Severe intraventricular haemorrhage (IVH grades 3, 4).

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Analysis 4.4

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 4 Intraventricular haemorrhage (IVH, all grades).

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Analysis 4.5

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 5 Periventricular leukomalacia (PVL).

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Analysis 4.6

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation).

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Analysis 4.7

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 7 Maternal blood loss of 500 mL or greater.

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Analysis 4.8

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 8 Intraventricular haemorrhage (IVH, grades 1 & 2).

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Analysis 4.9

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 9 Necrotising enterocolitis (NEC) confirmed by X‐ray or laparotomy).

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Analysis 4.11

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 11 Respiratory support (ventilator or CPAP).

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Analysis 4.14

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 14 Treatment for Patent Ductus Arteriosus (PDA) (medical and/or surgical).

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Analysis 4.15

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 15 Treatment for Retinopathy of Prematurity (RoP).

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Analysis 4.16

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 16 Hyperbilirubinemia (treated by phototherapy).

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Analysis 4.19

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 19 Blood transfusion in infant.

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Analysis 4.21

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 21 Late sepsis (after 3 days or as defined by trialists).

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Analysis 4.22

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 22 Hydrocephalus.

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Analysis 4.23

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 23 Temperature < 36.0^oC within 1 hour of birth.

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Analysis 4.28

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 28 Neurodevelopmental impairment at age two to three years.

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Analysis 4.31

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 31 Manual removal of placenta (denominator = vaginal births).

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Analysis 4.32

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 32 Prolonged third stage (>30 minutes) (denominator = vaginal births).

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Analysis 4.33

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 33 Blood transfusion for mother.

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Analysis 4.34

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 34 Postpartum infection in mother.

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Analysis 4.39

Comparison 4 DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention), Outcome 39 Fully breastfed or mixed feeding at infant discharge.

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Analysis 5.1

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 1 Death of baby (up to discharge).

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Analysis 5.2

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 2 Death or neurodevelopmental impairment at age two to three years.

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Analysis 5.3

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 3 Severe intraventricular haemorrhage (IVH grades 3, 4).

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Analysis 5.4

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 4 Intraventricular haemorrhage (IVH, all grades).

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Analysis 5.5

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 5 Periventricular leukomalacia (PVL).

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Analysis 5.6

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation).

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Analysis 5.8

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 8 Intraventricular haemorrhage (IVH, grades 1 & 2).

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Analysis 5.9

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 9 Necrotising enterocolitis (NEC) confirmed by X‐ray or laparotomy).

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Analysis 5.12

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 12 Duration of respiratory support (days).

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Analysis 5.13

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 13 Surfactant treatment (for severe RDS).

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Analysis 5.15

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 15 Treatment for Retinopathy of Prematurity (RoP).

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Analysis 5.19

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 19 Blood transfusion in infant.

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Analysis 5.21

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 21 Late sepsis (after 3 days or as defined by trialists).

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Analysis 5.22

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 22 Hydrocephalus.

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Analysis 5.24

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 24 Hb within 1^st 24 hour of birth (g/dL).

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Analysis 5.27

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 27 Home oxygen.

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Analysis 5.28

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 28 Neurodevelopmental impairment at age two to three years.

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Analysis 5.29

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 29 Severe visual impairment.

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Analysis 5.30

Comparison 5 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation), Outcome 30 Cerebral palsy (CP).

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Analysis 6.1

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 1 Death of baby (up to discharge).

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Analysis 6.2

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 2 Death or neurodevelopmental impairment at age two to three years.

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Analysis 6.3

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 3 Severe intraventricular haemorrhage (IVH grades 3, 4).

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Analysis 6.4

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 4 Intraventricular haemorrhage (IVH, all grades).

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Analysis 6.5

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 5 Periventricular leukomalacia (PVL).

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Analysis 6.6

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation).

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Analysis 6.8

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 8 Intraventricular haemorrhage (IVH, grades 1 & 2).

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Analysis 6.12

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 12 Duration of respiratory support (days).

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Analysis 6.13

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 13 Surfactant treatment (for severe RDS).

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Analysis 6.15

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 15 Treatment for Retinopathy of Prematurity (RoP).

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Analysis 6.19

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 19 Blood transfusion in infant.

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Analysis 6.21

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 21 Late sepsis (after 3 days or as defined by trialists).

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Analysis 6.22

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 22 Hydrocephalus.

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Analysis 6.24

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 24 Hb within 1^st 24 hour of birth (g/dL).

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Analysis 6.27

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 27 Home oxygen.

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Analysis 6.28

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 28 Neurodevelopmental impairment at age two to three years.

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Analysis 6.29

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 29 Severe visual impairment.

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Analysis 6.30

Comparison 6 DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention), Outcome 30 Cerebral palsy (CP).

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Analysis 7.1

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 1 Death of baby (up to discharge).

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Analysis 7.3

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 3 Severe intraventricular haemorrhage (IVH grades 3, 4).

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Analysis 7.4

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 4 Intraventricular haemorrhage (IVH, all grades).

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Analysis 7.5

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 5 Periventricular leukomalacia (PVL).

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Analysis 7.6

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation).

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Analysis 7.7

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 7 Maternal blood loss of 500 mL or greater.

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Analysis 7.8

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 8 Intraventricular haemorrhage (IVH, grades 1 & 2).

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Analysis 7.9

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 9 Necrotising enterocolitis (NEC) confirmed by X‐ray or laparotomy).

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Analysis 7.10

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 10 Respiratory Distress Syndrome (RDS).

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Analysis 7.11

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 11 Respiratory support (ventilator or CPAP).

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Analysis 7.12

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 12 Duration of respiratory support (days).

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Analysis 7.13

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 13 Surfactant treatment (for severe RDS).

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Analysis 7.14

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 14 Treatment for Patent Ductus Arteriosus (PDA) (medical and/or surgical).

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Analysis 7.15

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 15 Treatment for Retinopathy of Prematurity (RoP).

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Analysis 7.16

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 16 Hyperbilirubinemia (treated by phototherapy).

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Analysis 7.17

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 17 Inotropics for low blood pressure.

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Analysis 7.18

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 18 Low Apgar as defined by trialists (generally < 8 at 5 mins).

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Analysis 7.19

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 19 Blood transfusion in infant.

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Analysis 7.20

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 20 Volume of blood transfused (mL).

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Analysis 7.21

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 21 Late sepsis (after 3 days or as defined by trialists).

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Analysis 7.24

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 24 Hb within 1^st 24 hour of birth (g/dL).

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Analysis 7.25

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 25 Mean arterial blood pressure.

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Analysis 7.26

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 26 Length of infant stay in NICU (in weeks).

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Analysis 7.27

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 27 Home oxygen.

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Analysis 7.28

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 28 Neurodevelopmental impairment at age two to three years.

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Analysis 7.29

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 29 Severe visual impairment.

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Analysis 7.30

Comparison 7 UCM vs ECC (subgroup analysis by gestation), Outcome 30 Cerebral palsy (CP).

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Analysis 8.1

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 1 Death of baby (up to discharge).

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Analysis 8.3

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 3 Severe intraventricular haemorrhage (IVH grades 3, 4).

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Analysis 8.4

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 4 Intraventricular haemorrhage (IVH, all grades).

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Analysis 8.5

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 5 Periventricular leukomalacia (PVL).

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Analysis 8.6

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation).

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Analysis 8.7

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 7 Maternal blood loss of 500 mL or greater.

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Analysis 8.8

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 8 Intraventricular haemorrhage (IVH, grades 1 & 2).

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Analysis 8.9

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 9 Necrotising enterocolitis (NEC) confirmed by X‐ray or laparotomy).

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Analysis 8.10

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 10 Respiratory Distress Syndrome (RDS).

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Analysis 8.11

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 11 Respiratory support (ventilator or CPAP).

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Analysis 8.12

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 12 Duration of respiratory support (days).

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Analysis 8.13

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 13 Surfactant treatment (for severe RDS).

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Analysis 8.14

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 14 Treatment for Patent Ductus Arteriosus (PDA) (medical and/or surgical).

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Analysis 8.15

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 15 Treatment for Retinopathy of Prematurity (RoP).

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Analysis 8.16

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 16 Hyperbilirubinemia (treated by phototherapy).

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Analysis 8.17

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 17 Inotropics for low blood pressure.

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Analysis 8.18

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 18 Low Apgar as defined by trialists (generally < 8 at 5 mins).

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Analysis 8.19

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 19 Blood transfusion in infant (mL).

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Analysis 8.20

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 20 Volume of blood transfused.

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Analysis 8.21

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 21 Late sepsis (after 3 days or as defined by trialists).

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Analysis 8.24

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 24 Hb within 1^st 24 hour of birth (g/dL).

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Analysis 8.25

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 25 Mean arterial blood pressure (subgrouped by time after birth).

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Analysis 8.26

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 26 Length of infant stay in NICU.

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Analysis 8.27

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 27 Home oxygen.

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Analysis 8.28

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 28 Neurodevelopmental impairment at age two to three years.

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Analysis 8.29

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 29 Severe visual impairment.

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Analysis 8.30

Comparison 8 UCM vs ECC (subgroup analysis by type of intervention), Outcome 30 Cerebral palsy (CP).

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Analysis 9.1

Comparison 9 DCC with immediate neonatal care after cord clamping vs ECC (low risk of bias), Outcome 1 Death of baby (up to discharge).

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Analysis 9.3

Comparison 9 DCC with immediate neonatal care after cord clamping vs ECC (low risk of bias), Outcome 3 Severe intraventricular haemorrhage (IVH grades 3, 4).

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Analysis 9.4

Comparison 9 DCC with immediate neonatal care after cord clamping vs ECC (low risk of bias), Outcome 4 Intraventricular haemorrhage (IVH, all grades).

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Analysis 9.5

Comparison 9 DCC with immediate neonatal care after cord clamping vs ECC (low risk of bias), Outcome 5 Periventricular leukomalacia (PVL).

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Analysis 9.6

Comparison 9 DCC with immediate neonatal care after cord clamping vs ECC (low risk of bias), Outcome 6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation).

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Analysis 9.7

Comparison 9 DCC with immediate neonatal care after cord clamping vs ECC (low risk of bias), Outcome 7 Maternal blood loss of 500 mL or greater.

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Analysis 10.1

Comparison 10 DCC with immediate neonatal care with cord intact vs ECC (low risk of bias), Outcome 1 Death of baby (up to discharge).

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Analysis 10.2

Comparison 10 DCC with immediate neonatal care with cord intact vs ECC (low risk of bias), Outcome 2 Death or neurodevelopmental impairment in early years.

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Analysis 10.3

Comparison 10 DCC with immediate neonatal care with cord intact vs ECC (low risk of bias), Outcome 3 Severe intraventricular haemorrhage (IVH grades 3, 4).

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Analysis 10.4

Comparison 10 DCC with immediate neonatal care with cord intact vs ECC (low risk of bias), Outcome 4 Intraventricular haemorrhage (IVH, all grades).

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Analysis 10.5

Comparison 10 DCC with immediate neonatal care with cord intact vs ECC (low risk of bias), Outcome 5 Periventricular leukomalacia (PVL).

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Analysis 10.6

Comparison 10 DCC with immediate neonatal care with cord intact vs ECC (low risk of bias), Outcome 6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation).

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Analysis 10.7

Comparison 10 DCC with immediate neonatal care with cord intact vs ECC (low risk of bias), Outcome 7 Maternal blood loss of 500 mL or greater.

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Analysis 11.1

Comparison 11 DCC with immediate neonatal care after cord clamping vs UCM (low risk of bias), Outcome 1 Death of baby (up to discharge).

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Analysis 11.2

Comparison 11 DCC with immediate neonatal care after cord clamping vs UCM (low risk of bias), Outcome 2 Death or neurodevelopmental impairment in early years.

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Analysis 11.3

Comparison 11 DCC with immediate neonatal care after cord clamping vs UCM (low risk of bias), Outcome 3 Severe intraventricular haemorrhage (IVH grades 3, 4).

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Analysis 11.4

Comparison 11 DCC with immediate neonatal care after cord clamping vs UCM (low risk of bias), Outcome 4 Intraventricular haemorrhage (IVH, all grades).

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Analysis 11.5

Comparison 11 DCC with immediate neonatal care after cord clamping vs UCM (low risk of bias), Outcome 5 Periventricular leukomalacia (PVL).

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Analysis 11.6

Comparison 11 DCC with immediate neonatal care after cord clamping vs UCM (low risk of bias), Outcome 6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation).

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Analysis 12.1

Comparison 12 UCM vs ECC (low risk of bias), Outcome 1 Death of baby (up to discharge).

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Analysis 12.3

Comparison 12 UCM vs ECC (low risk of bias), Outcome 3 Severe intraventricular haemorrhage (IVH grades 3, 4).

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Analysis 12.4

Comparison 12 UCM vs ECC (low risk of bias), Outcome 4 Intraventricular haemorrhage (IVH, all grades).

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Analysis 12.5

Comparison 12 UCM vs ECC (low risk of bias), Outcome 5 Periventricular leukomalacia (PVL).

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Analysis 12.6

Comparison 12 UCM vs ECC (low risk of bias), Outcome 6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation).

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Analysis 12.7

Comparison 12 UCM vs ECC (low risk of bias), Outcome 7 Maternal blood loss of 500 mL or greater.

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Summary of findings for the main comparison. DCC with immediate neonatal care after cord clamping compared to ECC (subgroup analysis by gestation) for health problem or population

DCC with immediate neonatal care after cord clamping compared to ECC (subgroup analysis by gestation) for health problem or population
Patient or population: babies born preterm, and their mothers Setting: hospital births mostly in high‐income countries Intervention: delayed cord clamping (DCC) with immediate neonatal care after cord clamping Comparison: early cord clamping (ECC)
Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with ECC (subgroup analysis by gestation)	Risk with DCC with immediate neonatal care after cord clamping
Death of baby (up to discharge)	Study population		RR 0.73 (0.54 to 0.98)	2680 (20 RCTs)	⊕⊕⊕⊝ MODERATE ^{1 2}
	74 per 1000	54 per 1000 (40 to 72)
Death or neurodevelopmental impairment in early years	Study population		‐	(0 studies)	‐
	see comment	see comment
Severe intraventricular haemorrhage (IVH grades 3, 4)	Study population		RR 0.94 (0.63 to 1.39)	2058 (10 RCTs)	⊕⊕⊝⊝ LOW ^{3 4}
	48 per 1000	45 per 1000 (30 to 66)
Intraventricular haemorrhage (IVH, all grades)	Study population		RR 0.83 (0.70 to 0.99)	2333 (15 RCTs)	⊕⊕⊕⊕ HIGH ^{5 6}
	187 per 1000	155 per 1000 (131 to 185)
Periventricular leukomalacia (PVL)	Study population		RR 0.58 (0.26 to 1.30)	1544 (4 RCTs)	⊕⊕⊝⊝ LOW ⁷
	22 per 1000	13 per 1000 (6 to 28)
Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation)	Study population		RR 1.04 (0.94 to 1.14)	1644 (6 RCTs)	⊕⊕⊕⊕ HIGH ⁸
	494 per 1000	514 per 1000 (464 to 563)
Maternal blood loss of 500 mL or greater	Study population		RR 1.14 (0.07 to 17.63)	180 (2 RCTs)	⊕⊝⊝⊝ VERY LOW ^{9 10}
	11 per 1000	12 per 1000 (1 to 188)
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
¹ Although many of the included studies have unclear risk of bias, the large trial which provided 80% of the data is low risk of bias. No downgrade. ² Number of participants = 2680 and OIS > 11,000 (ref Tarnow‐Mordi 2017); number of events 171 less than the 300 calculated for confidence in findings; upper confidence interval close to the line of no difference. Downgrade 1. ³ 25% of data comes from studies where the risk of bias is unclear or high, however, the large study which provides 70% of data are low risk of bias. No downgrade. ⁴ Number of participants 2083; number of events 86 (< 300 generally required); CI crosses line of no difference. Downgrade 2. ⁵ 78% of data coming from studies of low risk of bias including the large study which is of low risk of bias. No downgrade. ⁶ Number of participants 2333; number of events 409. No downgrade. ⁷ Number of participants 1544 and number of events 26 (well below generally required 300). Downgrade 2. ⁸ 98% of data comes from trials of low risk of selection bias, including 1 large well‐conducted trial. No downgrade. ⁹ Although Selection bias is low risk of bias, incomplete outcome data is high risk of bias. Downgrade 1. ¹⁰ Only 180 women and 2 events. Downgrade 2.

Summary of findings for the main comparison. DCC with immediate neonatal care after cord clamping compared to ECC (subgroup analysis by gestation) for health problem or population

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Summary of findings 2. DCC with immediate neonatal care with cord intact compared to ECC in babies born preterm

DCC with immediate neonatal care with cord intact compared to ECC in babies born preterm
Patient or population: babies born preterm, and their mothers Setting: hospital births in UK Intervention: delayed cord clamping (DCC) with immediate neonatal care with cord intact Comparison: early cord clamping (ECC)
Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with ECC (subgroup analysis by gestation)	Risk with DCC with immediate neonatal care with cord intact
Death of baby (up to discharge)	Study population		RR 0.47 (0.20 to 1.11)	270 (1 RCT)	⊕⊕⊝⊝ LOW ¹
	111 per 1000	52 per 1000 (22 to 123)
Death or neurodevelopmental impairment at age 2 to 3 years	Study population		RR 0.61 (0.39 to 0.96)	218 (1 RCT)	⊕⊕⊝⊝ LOW ²
	340 per 1000	207 per 1000 (133 to 326)
Severe intraventricular haemorrhage (IVH grades 3, 4)	Study population		RR 0.84 (0.29 to 2.45)	266 (1 RCT)	⊕⊕⊝⊝ LOW ³
	53 per 1000	45 per 1000 (15 to 130)
Intraventricular haemorrhage (IVH, all grades)	Study population		RR 0.90 (0.64 to 1.26)	266 (1 RCT)	⊕⊕⊝⊝ LOW ⁴
	356 per 1000	320 per 1000 (228 to 449)
Periventricular leukomalacia (PVL)	Study population		RR 0.86 (0.32 to 2.31)	266 (1 RCT)	⊕⊕⊝⊝ LOW ⁵
	61 per 1000	52 per 1000 (19 to 140)
Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation)	Study population		RR 0.95 (0.66 to 1.37)	249 (1 RCT)	⊕⊕⊝⊝ LOW ⁶
	325 per 1000	309 per 1000 (215 to 445)
Maternal blood loss of 500 mL or greater	Study population		RR 0.94 (0.72 to 1.22)	254 (1 RCT)	⊕⊕⊝⊝ LOW ^{7 8}
	476 per 1000	447 per 1000 (343 to 580)
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
¹ Only one small study (N = 270); wide CI crossing line of no effect and very few events (n = 22). Downgrade 2. ² Only one small study (N = 218); wide CI crossing line of no effect and very few events (n = 59). Downgrade 2. ³ Only one small study (N = 266); wide CI crossing line of no effect and very few events (n = 13). Downgrade 2. ⁴ Only one small study (N = 266); wide CI crossing line of no effect and few events (n = 90). Downgrade 2. ⁵ Only one small study (N = 266); wide CI crossing line of no effect and very few events (n = 15). Downgrade 2. ⁶ Only one small study (N = 249); wide CI crossing line of no effect and few events (n = 79). Downgrade 2. ⁷ High risk of bias through not being able to blind clinicians or women and this outcome. Downgrade 1. ⁸ Only one small study (N = 254); wide CI crossing line of no effect and few events (n = 117). Downgrade 1.

Summary of findings 2. DCC with immediate neonatal care with cord intact compared to ECC in babies born preterm

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Summary of findings 3. DCC with immediate neonatal care after cord clamping compared to UCM in babes born preterm

DCC with immediate neonatal care after cord clamping compared to UCM in babies born preterm
Patient or population: babies born preterm, and their mothers Setting: hospital births mostly in high‐income countries Intervention: delayed cord clamping (DCC) with immediate neonatal care after cord clamping Comparison: umbilical cord milking (UCM).
Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with UCM (subgroup analysis by gestation)	Risk with DCC with immediate neonatal care after cord clamping
Death of baby (up to discharge)	Study population		RR 2.14 (0.93 to 4.93)	322 (3 RCTs)	⊕⊕⊝⊝ LOW ^{1 2}
	44 per 1000	94 per 1000 (41 to 216)
Death or neurodevelopmental impairment at age 2 to 3 years	Study population		RR 1.67 (0.78 to 3.57)	195 (2 RCTs)	⊕⊝⊝⊝ VERY LOW ^{3 4}
	162 per 1000	270 per 1000 (126 to 577)
Severe intraventricular haemorrhage (IVH grades 3, 4)	Study population		RR 2.63 (0.11 to 61.88)	58 (1 RCT)	⊕⊕⊝⊝ LOW ^{5 6}
	0 per 1000	0 per 1000 (0 to 0)
Intraventricular haemorrhage (IVH, all grades)	Study population		RR 1.32 (0.55 to 3.17)	125 (2 RCTs)	⊕⊝⊝⊝ VERY LOW ^{7 8}
	129 per 1000	170 per 1000 (71 to 409)
Periventricular leukomalacia (PVL)	Study population		not estimable	58 (1 RCT)	⊕⊕⊝⊝ LOW ^{9 10}
	0 per 1000	0 per 1000 (0 to 0)
Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation)	Study population		RR 1.53 (0.43 to 5.48)	125 (2 RCTs)	⊕⊕⊝⊝ LOW ^{11 12}
	48 per 1000	74 per 1000 (21 to 265)
Maternal blood loss of 500 mL or greater	Study population		‐	(0 studies)	‐
	see comment	see comment
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
¹ Risk of bias: two out of three studies were low risk of bias for sequence generation, allocation concealment and incomplete outcome data and provided over 90% of data. No downgrade. ² Imprecision: small number of participants (N = 322); very few events (n = 24) and wide 95% CI crossing line of no difference. Downgrade 2. ³ One study providing over 70% of data was high risk of attrition bias and selective outcome reporting bias. Downgrade 1. ⁴ Wide CI crossing line of no difference, small number of participants (N = 195) and few events (n = 41). Downgrade 2. ⁵ One small study ‐ low risk of bias. No downgrade. ⁶ Small sample size (N = 58), only 1 event and wide 95% CI crossing line of no difference. Downgrade 2. ⁷ One study providing over 50% of data was unclear for selection bias. Downgrade 1. ⁸ Small sample size (N = 125), few events (n = 19) and wide 95% CI crossing line of no difference. Downgrade 2. ⁹ Risk of bias: low for sequence generation, allocation concealment and incomplete outcome data. No downgrade. ¹⁰ Imprecision: small sample size (N = 58) and no events. Downgrade 2. ¹¹ One study provided 82% of the data were assessed as low risk of bias. No downgrade. ¹² Small sample size (N = 125), very few events (n = 9) and wide 95% CI crossing line of no difference. Downgrade 2.

Summary of findings 3. DCC with immediate neonatal care after cord clamping compared to UCM in babes born preterm

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Summary of findings 4. UCM compared to ECC in babies born preterm

UCM compared to ECC in babies born preterm
Patient or population: babies born preterm, and their mothers. Setting: hospital births mostly in high‐income countries. Intervention: umbilical cord milking(UCM) Comparison: early cord clamping (ECC).
Outcomes	*Anticipated absolute effects^ (95% CI)**		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with ECC (subgroup analysis by gestation)	Risk with UCM
Death of baby (up to discharge)	Study population		RR 0.81 (0.47 to 1.41)	931 (9 RCTs)	⊕⊕⊝⊝ LOW ^{1 2}
	60 per 1000	48 per 1000 (28 to 84)
Death or neurodevelopmental impairment at age 2 to 3 years	Study population		‐	(0 studies)	‐
	see comment	see comment
Severe intraventricular haemorrhage (IVH grades 3, 4)	Study population		RR 0.75 (0.39 to 1.45)	618 (6 RCTs)	⊕⊕⊝⊝ LOW ^{3 4}
	64 per 1000	48 per 1000 (25 to 93)
Intraventricular haemorrhage (IVH, all grades)	Study population		RR 0.85 (0.62 to 1.18)	716 (8 RCTs)	⊕⊕⊕⊝ MODERATE ^{5 6}
	270 per 1000	230 per 1000 (168 to 319)
Periventricular leukomalacia (PVL)	Study population		RR 0.63 (0.15 to 2.63)	315 (3 RCTs)	⊕⊕⊝⊝ LOW ^{7 8}
	31 per 1000	20 per 1000 (5 to 82)
Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation)	Study population		RR 1.03 (0.64 to 1.66)	682 (7 RCTs)	⊕⊕⊝⊝ LOW ^{9 10 11}
	198 per 1000	204 per 1000 (127 to 329)
Maternal blood loss of 500 mL or greater	Study population		not estimable	200 (1 RCT)	⊕⊕⊝⊝ LOW ^{12 13}
	0 per 1000	0 per 1000 (0 to 0)
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
¹ Five out of nine studies were low risk of selection bias and provided over 50% of data. No downgrade. ² Not many events (n = 50) out of 931 babies, and wide 95% CI crossing line of no difference. Downgraded 2 ³ Three out of six studies were low risk of selection bias and provided over 50% of data. No downgrade ⁴ Not a large sample size (N = 618), few events (n = 36) and wide 95% CI crossing line of no difference. Downgrade 2. ⁵ Four out of eight studies were low risk of selection bias and contributed over 50% of data. No downgrade ⁶ Wide CI crossing line of no difference. Not a large sample size (N = 716). 181 events. Downgrade 1. ⁷ Two out of three studies were low risk of selection bias and provided over 60% of data. No downgrade. ⁸ Small sample size (N = 315), very few events (n = 8) and wide 95% CI crossing line of no difference. Downgrade 2. ⁹ Four out of seven studies were low risk of selection bias and provided over 60% of data. No downgrade. ¹⁰ Heterogeneity I² = 50%. Downgrade 1. ¹¹ Wide CI crossing line of no difference. Not a large sample size (N = 682). 141 events. Downgrade 1. ¹² Risk of bias: low for sequence generation, allocation concealment and incomplete outcome data. No downgrade. ¹³ Imprecision: small sample size (N = 200) and no events. Downgrade 2.

Summary of findings 4. UCM compared to ECC in babies born preterm

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Comparison 1. DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death of baby (up to discharge) Show forest plot	20	2680	Risk Ratio (M‐H, Random, 95% CI)	0.73 [0.54, 0.98]

1.1 < 32‐34 weeks gestation	13	2108	Risk Ratio (M‐H, Random, 95% CI)	0.71 [0.52, 0.96]
1.2 > 32‐34 weeks gestation	3	237	Risk Ratio (M‐H, Random, 95% CI)	5.18 [0.25, 105.47]
1.3 Mixed gestation	4	335	Risk Ratio (M‐H, Random, 95% CI)	0.80 [0.09, 7.04]
2 Death or neurodevelopmental impairment in early years	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3 Severe intraventricular haemorrhage (IVH grades 3, 4) Show forest plot	10	2058	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.63, 1.39]

3.1 < 32‐34 weeks gestation	9	1972	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.64, 1.42]
3.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.3 Mixed gestation	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.58 [0.05, 6.11]
4 Intraventricular haemorrhage (IVH, all grades) Show forest plot	15	2333	Risk Ratio (M‐H, Random, 95% CI)	0.83 [0.70, 0.99]

4.1 < 32‐34 weeks gestation	11	1988	Risk Ratio (M‐H, Random, 95% CI)	0.76 [0.56, 1.02]
4.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.3 Mixed gestation	4	345	Risk Ratio (M‐H, Random, 95% CI)	0.66 [0.38, 1.16]
5 Periventricular leukomalacia (PVL) Show forest plot	4	1544	Risk Ratio (M‐H, Random, 95% CI)	0.58 [0.26, 1.30]

5.1 < 32‐34 weeks gestation	4	1544	Risk Ratio (M‐H, Random, 95% CI)	0.58 [0.26, 1.30]
5.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation) Show forest plot	6	1644	Risk Ratio (M‐H, Random, 95% CI)	1.04 [0.94, 1.14]

6.1 < 32‐34 weeks gestation	6	1644	Risk Ratio (M‐H, Random, 95% CI)	1.04 [0.94, 1.14]
6.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7 Maternal blood loss of 500 mL or greater Show forest plot	2	180	Risk Ratio (M‐H, Random, 95% CI)	1.14 [0.07, 17.63]

7.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.2 > 32‐34 weeks gestation	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.3 Mixed gestation	1	94	Risk Ratio (M‐H, Random, 95% CI)	1.14 [0.07, 17.63]
8 Intraventricular haemorrhage (IVH, grades 1 & 2) Show forest plot	9	1968	Risk Ratio (M‐H, Random, 95% CI)	0.72 [0.51, 1.02]

8.1 < 32‐34 weeks gestation	8	1882	Risk Ratio (M‐H, Random, 95% CI)	0.68 [0.45, 1.03]
8.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.3 Mixed gestation	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.37, 2.18]
9 Necrotising enterocolitis (NEC) confirmed by X‐ray or laparotomy) Show forest plot	11	2010	Risk Ratio (M‐H, Random, 95% CI)	0.91 [0.64, 1.28]

9.1 < 32‐34 weeks gestation	10	1916	Risk Ratio (M‐H, Random, 95% CI)	0.86 [0.60, 1.22]
9.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.3 Mixed gestation	1	94	Risk Ratio (M‐H, Random, 95% CI)	2.84 [0.58, 13.92]
10 Respiratory Distress Syndrome (RDS) Show forest plot	7	457	Risk Ratio (M‐H, Random, 95% CI)	1.09 [0.86, 1.38]

10.1 < 32‐34 weeks gestation	3	165	Risk Ratio (M‐H, Random, 95% CI)	1.21 [0.64, 2.27]
10.2 > 32‐34 weeks gestation	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.19, 3.30]
10.3 Mixed gestation	3	206	Risk Ratio (M‐H, Random, 95% CI)	1.32 [0.52, 3.36]
11 Respiratory support (ventilator or CPAP) Show forest plot	6	325	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.77, 1.16]

11.1 < 32‐34 weeks gestation	5	220	Risk Ratio (M‐H, Random, 95% CI)	0.96 [0.78, 1.18]
11.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.3 Mixed gestation	1	105	Risk Ratio (M‐H, Random, 95% CI)	0.57 [0.16, 2.09]
12 Duration of respiratory support (in days) Show forest plot	1	42	Mean Difference (IV, Random, 95% CI)	‐0.60 [‐3.04, 1.84]

12.1 < 32‐34 weeks gestation	1	42	Mean Difference (IV, Random, 95% CI)	‐0.60 [‐3.04, 1.84]
12.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
13 Surfactant treatment (for severe RDS) Show forest plot	3	145	Risk Ratio (M‐H, Random, 95% CI)	0.80 [0.50, 1.28]

13.1 < 32‐34 weeks gestation	3	145	Risk Ratio (M‐H, Random, 95% CI)	0.80 [0.50, 1.28]
13.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14 Treatment for Patent Ductus Arteriosus (PDA) (medical and/or surgical) Show forest plot	10	2046	Risk Ratio (M‐H, Random, 95% CI)	1.12 [0.99, 1.26]

14.1 < 32‐34 weeks gestation	9	1952	Risk Ratio (M‐H, Random, 95% CI)	1.12 [0.99, 1.26]
14.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.3 Mixed gestation	1	94	Risk Ratio (M‐H, Random, 95% CI)	1.14 [0.24, 5.34]
15 Treatment for Retinopathy of Prematurity (RoP) Show forest plot	8	1827	Risk Ratio (M‐H, Random, 95% CI)	0.83 [0.62, 1.12]

15.1 < 32‐34 weeks gestation	8	1827	Risk Ratio (M‐H, Random, 95% CI)	0.83 [0.62, 1.12]
15.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16 Hyperbilirubinemia (treated by phototherapy) Show forest plot	8	495	Risk Ratio (M‐H, Random, 95% CI)	1.05 [0.95, 1.16]

16.1 < 32‐34 weeks gestation	3	114	Risk Ratio (M‐H, Random, 95% CI)	1.01 [0.91, 1.11]
16.2 > 32‐34 weeks gestation	2	123	Risk Ratio (M‐H, Random, 95% CI)	0.73 [0.38, 1.41]
16.3 Mixed gestation	3	258	Risk Ratio (M‐H, Random, 95% CI)	1.17 [0.93, 1.47]
17 Inotropics for low blood pressure Show forest plot	5	250	Risk Ratio (M‐H, Random, 95% CI)	0.37 [0.17, 0.81]

17.1 < 32‐34 weeks gestation	5	250	Risk Ratio (M‐H, Random, 95% CI)	0.37 [0.17, 0.81]
17.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18 Low Apgar as defined by trialists (generally < 8 at 5 mins) Show forest plot	4	1721	Risk Ratio (M‐H, Random, 95% CI)	1.07 [0.70, 1.63]

18.1 < 32‐34 weeks gestation	3	1637	Risk Ratio (M‐H, Random, 95% CI)	1.01 [0.62, 1.62]
18.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.3 Mixed gestation	1	84	Risk Ratio (M‐H, Random, 95% CI)	1.32 [0.53, 3.31]
19 Blood transfusion in infant Show forest plot	11	2280	Risk Ratio (M‐H, Random, 95% CI)	0.66 [0.50, 0.86]

19.1 < 32‐34 weeks gestation	8	1995	Risk Ratio (M‐H, Random, 95% CI)	0.64 [0.47, 0.87]
19.2 > 32‐34 weeks gestation	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.3 Mixed gestation	2	199	Risk Ratio (M‐H, Random, 95% CI)	0.67 [0.26, 1.74]
20 Volume of blood transfused (mL) Show forest plot	1	72	Mean Difference (IV, Random, 95% CI)	‐6.0 [‐26.11, 14.11]

20.1 < 32‐34 weeks gestation	1	72	Mean Difference (IV, Random, 95% CI)	‐6.0 [‐26.11, 14.11]
20.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
21 Late sepsis (after 3 days or as defined by trialists) Show forest plot	10	2017	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.56, 1.10]

21.1 < 32‐34 weeks gestation	9	1923	Risk Ratio (M‐H, Random, 95% CI)	0.76 [0.52, 1.11]
21.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.3 Mixed gestation	1	94	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.43, 1.79]
22 Hydrocephalus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23 Temperature < 36.0^oC within 1 hour of birth Show forest plot	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

23.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.2 > 32‐34 weeks gestation	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
24 Hb within 1^st 24 hour of birth (g/dL) Show forest plot	1	42	Mean Difference (IV, Random, 95% CI)	0.80 [‐0.02, 1.62]

24.1 < 32‐34 weeks gestation	1	42	Mean Difference (IV, Random, 95% CI)	0.80 [‐0.02, 1.62]
24.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25 Mean arterial blood pressure in early hours after birth (mm Hg) Show forest plot	4	208	Mean Difference (IV, Random, 95% CI)	2.87 [1.09, 4.64]

25.1 < 32‐34 weeks gestation	4	208	Mean Difference (IV, Random, 95% CI)	2.87 [1.09, 4.64]
25.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26 Length of infant stay in NICU	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.1 < 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
27 Home oxygen Show forest plot	2	101	Risk Ratio (M‐H, Random, 95% CI)	0.47 [0.06, 3.72]

27.1 < 32‐34 weeks gestation	2	101	Risk Ratio (M‐H, Random, 95% CI)	0.47 [0.06, 3.72]
27.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28 Neurodevelopmental impairment at age two to three years (Baileys 11 MDI < 70)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29 Severe visual impairment	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30 Cerebral palsy (CP)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31 Manual removal of placenta (denominator = vaginal births)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32 Prolonged third stage (> 30 minutes) (denominator = vaginal births)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33 Blood transfusion for mother Show forest plot	1	1176	Risk Ratio (M‐H, Random, 95% CI)	0.67 [0.36, 1.24]

33.1 < 32‐34 weeks gestation	1	1176	Risk Ratio (M‐H, Random, 95% CI)	0.67 [0.36, 1.24]
33.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34 Postpartum infection in mother	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35 Rhesus isoimmunisation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
36 Psychological well being in mother	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.1 < 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.2 > 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.3 Mixed gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37 Bonding	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.1 < 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.2 > 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.3 Mixed gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
38 Breastfeeding initiation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39 Fully breastfed or mixed feeding at infant discharge Show forest plot	1	94	Risk Ratio (M‐H, Random, 95% CI)	1.11 [1.00, 1.23]

39.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.3 Mixed gestation	1	94	Risk Ratio (M‐H, Random, 95% CI)	1.11 [1.00, 1.23]
40 Maternal anxiety	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
41 Mothers' views	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.1 < 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.2 > 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.3 Mixed gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 1. DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by gestation)

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Comparison 2. DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death of baby (up to discharge) Show forest plot	20	2680	Risk Ratio (M‐H, Random, 95% CI)	0.73 [0.54, 0.98]

1.1 DCC < 1 min and baby level with uterus	1	46	Risk Ratio (M‐H, Random, 95% CI)	0.20 [0.01, 3.95]
1.2 DCC < 1 min and baby held low	7	318	Risk Ratio (M‐H, Random, 95% CI)	0.50 [0.19, 1.30]
1.3 DCC 1‐2 mins and baby level with uterus	2	172	Risk Ratio (M‐H, Random, 95% CI)	1.15 [0.07, 17.80]
1.4 DCC 1‐2 mins and baby held low	3	1710	Risk Ratio (M‐H, Random, 95% CI)	0.72 [0.52, 1.00]
1.5 DCC > 2 mins and baby level with uterus	3	181	Risk Ratio (M‐H, Random, 95% CI)	0.67 [0.02, 28.73]
1.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
1.7 Mixed interventions or unclear	4	253	Risk Ratio (M‐H, Random, 95% CI)	2.28 [0.57, 9.13]
2 Death or neurodevelopmental impairment at age two to three years	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3 Severe intraventricular haemorrhage (IVH grades 3, 4) Show forest plot	10	2058	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.63, 1.39]

3.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.2 DCC < 1 min and baby held low	6	335	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.40, 2.21]
3.3 DCC 1‐2 mins and baby level with uterus	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.58 [0.05, 6.11]
3.4 DCC 1‐2 mins and baby held low	1	1541	Risk Ratio (M‐H, Random, 95% CI)	0.91 [0.57, 1.44]
3.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.7 Mixed interventions or unclear	2	96	Risk Ratio (M‐H, Random, 95% CI)	2.96 [0.34, 25.69]
4 Intraventricular haemorrhage (IVH, all grades) Show forest plot	15	2333	Risk Ratio (M‐H, Random, 95% CI)	0.83 [0.70, 0.99]

4.1 DCC < 1 min and baby level with uterus	1	31	Risk Ratio (M‐H, Random, 95% CI)	0.35 [0.02, 8.08]
4.2 DCC < 1 min and baby held low	6	278	Risk Ratio (M‐H, Random, 95% CI)	0.66 [0.41, 1.06]
4.3 DCC 1‐2 mins and baby level with uterus	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.84 [0.37, 1.87]
4.4 DCC 1‐2 mins and baby held low	2	1646	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.76, 1.16]
4.5 DCC > 2 mins and baby level with uterus	1	94	Risk Ratio (M‐H, Random, 95% CI)	0.38 [0.02, 9.04]
4.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.7 Mixed interventions or unclear	4	198	Risk Ratio (M‐H, Random, 95% CI)	0.66 [0.31, 1.42]
5 Periventricular leukomalacia (PVL) Show forest plot	4	1544	Risk Ratio (M‐H, Random, 95% CI)	0.58 [0.26, 1.30]

5.1 DCC < 1 min and baby level with uterus	1	31	Risk Ratio (M‐H, Random, 95% CI)	3.19 [0.14, 72.69]
5.2 DCC < 1 min and baby held low	2	102	Risk Ratio (M‐H, Random, 95% CI)	0.17 [0.01, 3.02]
5.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.4 DCC 1‐2 mins and baby held low	1	1411	Risk Ratio (M‐H, Random, 95% CI)	0.57 [0.24, 1.36]
5.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation) Show forest plot	6	1644	Risk Ratio (M‐H, Random, 95% CI)	1.04 [0.94, 1.14]

6.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.2 DCC < 1 min and baby held low	5	205	Risk Ratio (M‐H, Random, 95% CI)	0.82 [0.57, 1.17]
6.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.4 DCC 1‐2 mins and baby held low	1	1439	Risk Ratio (M‐H, Random, 95% CI)	1.06 [0.96, 1.16]
6.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7 Maternal blood loss of 500 mL or greater Show forest plot	2	180	Risk Ratio (M‐H, Random, 95% CI)	1.14 [0.07, 17.63]

7.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.3 DCC 1‐2 mins and baby level with uterus	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.5 DCC > 2 mins and baby held level with uterus	1	94	Risk Ratio (M‐H, Random, 95% CI)	1.14 [0.07, 17.63]
7.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8 Intraventricular haemorrhage (IVH, grades 1 & 2) Show forest plot	9	1968	Risk Ratio (M‐H, Random, 95% CI)	0.72 [0.51, 1.02]

8.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.2 DCC < 1 min and baby held low	5	245	Risk Ratio (M‐H, Random, 95% CI)	0.65 [0.37, 1.15]
8.3 DCC 1‐2 mins and baby level with uterus	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.37, 2.18]
8.4 DCC 1‐2 mins and baby held low	1	1541	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.74, 1.22]
8.5 DCC > 2 mins and baby held level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.7 Mixed interventions or unclear	2	96	Risk Ratio (M‐H, Random, 95% CI)	0.41 [0.18, 0.95]
9 Necrotising enterocolitis (NEC) confirmed by X‐ray or laparotomy) Show forest plot	11	2010	Risk Ratio (M‐H, Random, 95% CI)	0.91 [0.64, 1.28]

9.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.2 DCC < 1 min and baby held low	7	368	Risk Ratio (M‐H, Random, 95% CI)	0.59 [0.28, 1.27]
9.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.4 DCC 1‐2 mins and baby held low	1	1446	Risk Ratio (M‐H, Random, 95% CI)	0.90 [0.60, 1.37]
9.5 DCC > 2 mins and baby held level with uterus	1	94	Risk Ratio (M‐H, Random, 95% CI)	2.84 [0.58, 13.92]
9.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.7 Mixed interventions or unclear	2	102	Risk Ratio (M‐H, Random, 95% CI)	1.75 [0.40, 7.73]
10 Respiratory Distress Syndrome (RDS) Show forest plot	6	367	Risk Ratio (M‐H, Random, 95% CI)	1.09 [0.86, 1.38]

10.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.2 DCC < 1 min and baby held low	2	75	Risk Ratio (M‐H, Random, 95% CI)	1.21 [0.64, 2.27]
10.3 DCC 1‐2 mins and baby level with uterus	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.19, 3.30]
10.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.5 DCC > 2 mins and baby held level with uterus	1	94	Risk Ratio (M‐H, Random, 95% CI)	0.71 [0.25, 2.01]
10.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.7 Mixed interventions or unclear	2	112	Risk Ratio (M‐H, Random, 95% CI)	2.12 [0.75, 5.99]
11 Respiratory support (ventilator or CPAP) Show forest plot	6	325	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.77, 1.16]

11.1 DCC < 1 min and baby level with uterus	1	46	Risk Ratio (M‐H, Random, 95% CI)	1.0 [0.49, 2.06]
11.2 DCC < 1 min and baby held low	2	75	Risk Ratio (M‐H, Random, 95% CI)	1.13 [0.80, 1.61]
11.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.4 DCC 1‐2 mins and baby held low	2	144	Risk Ratio (M‐H, Random, 95% CI)	0.74 [0.39, 1.40]
11.5 DCC > 2 mins and baby held level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.7 Mixed interventions or unclear	1	60	Risk Ratio (M‐H, Random, 95% CI)	0.88 [0.65, 1.17]
12 Duration of respiratory support Show forest plot	1	42	Mean Difference (IV, Random, 95% CI)	‐0.60 [‐3.04, 1.84]

12.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.7 Mixed interventions or unclear	1	42	Mean Difference (IV, Random, 95% CI)	‐0.60 [‐3.04, 1.84]
13 Surfactant treatment (for severe RDS) Show forest plot	3	145	Risk Ratio (M‐H, Random, 95% CI)	0.80 [0.50, 1.28]

13.1 DCC < 1 min and baby level with uterus	1	46	Risk Ratio (M‐H, Random, 95% CI)	1.5 [0.49, 4.62]
13.2 DCC < 1 min and baby held low	1	39	Risk Ratio (M‐H, Random, 95% CI)	1.05 [0.31, 3.62]
13.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.7 Mixed interventions or unclear	1	60	Risk Ratio (M‐H, Random, 95% CI)	0.65 [0.37, 1.14]
14 Treatment for Patent Ductus Arteriosus (PDA) (medical and/or surgical) Show forest plot	10	2046	Risk Ratio (M‐H, Random, 95% CI)	1.12 [0.99, 1.26]

14.1 DCC < 1 min and baby level with uterus	1	46	Risk Ratio (M‐H, Random, 95% CI)	1.0 [0.22, 4.45]
14.2 DCC < 1 min and baby held low	4	174	Risk Ratio (M‐H, Random, 95% CI)	1.29 [0.88, 1.90]
14.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.4 DCC 1‐2 mins and baby held low	2	1630	Risk Ratio (M‐H, Random, 95% CI)	1.10 [0.90, 1.36]
14.5 DCC > 2 mins and baby level with uterus	1	94	Risk Ratio (M‐H, Random, 95% CI)	1.14 [0.24, 5.34]
14.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.7 Mixed interventions or unclear	2	102	Risk Ratio (M‐H, Random, 95% CI)	0.55 [0.24, 1.26]
15 Treatment for Retinopathy of Prematurity (RoP) Show forest plot	8	1827	Risk Ratio (M‐H, Random, 95% CI)	0.83 [0.62, 1.12]

15.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.2 DCC < 1 min and baby held low	4	226	Risk Ratio (M‐H, Random, 95% CI)	1.01 [0.69, 1.46]
15.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.4 DCC 1‐2 mins and baby held low	2	1499	Risk Ratio (M‐H, Random, 95% CI)	0.52 [0.11, 2.44]
15.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.7 Mixed interventions or unclear	2	102	Risk Ratio (M‐H, Random, 95% CI)	0.39 [0.13, 1.15]
16 Hyperbilirubinemia (treated by phototherapy) Show forest plot	8	495	Risk Ratio (M‐H, Random, 95% CI)	1.05 [0.95, 1.16]

16.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.2 DCC < 1 min and baby held low	2	76	Risk Ratio (M‐H, Random, 95% CI)	1.00 [0.91, 1.11]
16.3 DCC 1‐2 mins and baby level with uterus	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.65 [0.23, 1.84]
16.4 DCC 1‐2 mins and baby held low	1	104	Risk Ratio (M‐H, Random, 95% CI)	1.40 [1.03, 1.88]
16.5 DCC > 2 mins and baby level with uterus	2	131	Risk Ratio (M‐H, Random, 95% CI)	1.11 [0.91, 1.36]
16.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.7 Mixed interventions or unclear	2	98	Risk Ratio (M‐H, Random, 95% CI)	0.98 [0.70, 1.37]
17 Inotropics for low blood pressure Show forest plot	5	250	Risk Ratio (M‐H, Random, 95% CI)	0.37 [0.17, 0.81]

17.1 DCC < 1 min and baby level with uterus	1	46	Risk Ratio (M‐H, Random, 95% CI)	0.67 [0.12, 3.62]
17.2 DCC < 1 min and baby held low	3	162	Risk Ratio (M‐H, Random, 95% CI)	0.21 [0.06, 0.80]
17.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.7 Mixed interventions or unclear	1	42	Risk Ratio (M‐H, Random, 95% CI)	0.43 [0.13, 1.44]
18 Low Apgar as defined by trialists (generally < 8 at 5 mins) Show forest plot	4	1721	Risk Ratio (M‐H, Random, 95% CI)	1.07 [0.70, 1.63]

18.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.2 DCC < 1 min and baby held low	1	39	Risk Ratio (M‐H, Random, 95% CI)	0.75 [0.29, 1.96]
18.3 DCC 1‐2 mins and baby level with uterus	1	84	Risk Ratio (M‐H, Random, 95% CI)	1.32 [0.53, 3.31]
18.4 DCC 1‐2 mins and baby held low	1	1560	Risk Ratio (M‐H, Random, 95% CI)	1.04 [0.59, 1.83]
18.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.7 Mixed interventions or unclear	1	38	Risk Ratio (M‐H, Random, 95% CI)	5.4 [0.31, 93.42]
19 Blood transfusion in infant Show forest plot	11	2280	Risk Ratio (M‐H, Random, 95% CI)	0.66 [0.50, 0.86]

19.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.2 DCC < 1 min and baby held low	4	266	Risk Ratio (M‐H, Random, 95% CI)	0.68 [0.50, 0.92]
19.3 DCC 1‐2 mins and baby level with uterus	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.4 DCC 1‐2 mins and baby held low	3	1736	Risk Ratio (M‐H, Random, 95% CI)	0.44 [0.13, 1.46]
19.5 DCC > 2 mins and baby level with uterus	1	94	Risk Ratio (M‐H, Random, 95% CI)	0.76 [0.23, 2.51]
19.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.7 Mixed interventions or unclear	2	98	Risk Ratio (M‐H, Random, 95% CI)	0.57 [0.27, 1.23]
20 Volume of blood transfused (mL) Show forest plot	1	72	Mean Difference (IV, Random, 95% CI)	‐6.0 [‐26.11, 14.11]

20.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.2 DCC < 1 min and baby held low	1	72	Mean Difference (IV, Random, 95% CI)	‐6.0 [‐26.11, 14.11]
20.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
21 Late sepsis (after 3 days or as defined by trialists) Show forest plot	10	2017	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.56, 1.10]

21.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.2 DCC < 1 min and baby held low	5	297	Risk Ratio (M‐H, Random, 95% CI)	0.70 [0.39, 1.25]
21.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.4 DCC 1‐2 mins and baby held low	2	1524	Risk Ratio (M‐H, Random, 95% CI)	0.80 [0.35, 1.81]
21.5 DCC > 2 mins and baby level with uterus	1	94	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.43, 1.79]
21.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.7 Mixed interventions or unclear	2	102	Risk Ratio (M‐H, Random, 95% CI)	0.81 [0.23, 2.87]
22 Hydrocephalus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23 Temperature < 36.0^oC within 1 hour of birth Show forest plot	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

23.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.3 DCC 1‐2 mins and baby level with uterus	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
24 Hb within 1^st 24 hour of birth (g/dL) Show forest plot	1	42	Mean Difference (IV, Random, 95% CI)	0.80 [‐0.02, 1.62]

24.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.7 Mixed interventions or unclear	1	42	Mean Difference (IV, Random, 95% CI)	0.80 [‐0.02, 1.62]
25 Mean arterial blood pressure in early hours after birth (mm Hg) Show forest plot	4	208	Mean Difference (IV, Random, 95% CI)	2.87 [1.09, 4.64]

25.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.2 DCC < 1 min and baby held low	3	169	Mean Difference (IV, Random, 95% CI)	2.57 [0.69, 4.45]
25.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.4 DCC 1‐2 mins and baby held low	1	39	Mean Difference (IV, Random, 95% CI)	5.34 [‐0.06, 10.74]
25.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26 Length of infant stay in NICU	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
27 Home oxygen Show forest plot	2	101	Risk Ratio (M‐H, Random, 95% CI)	0.47 [0.06, 3.72]

27.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.2 DCC < 1 min and baby held low	2	101	Risk Ratio (M‐H, Random, 95% CI)	0.47 [0.06, 3.72]
27.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28 Neurodevelopmental impairment at age two to three years	0		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
28.1 DCC < 1 min and baby level with uterus	0		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.2 DCC < 1 min and baby held low	0		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.3 DCC 1‐2 mins and baby level with uterus	0		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.4 DCC 1‐2 mins and baby held low	0		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.5 DCC > 2 mins and baby level with uterus	0		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.6 DCC > 2 mins and baby held low	0		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.7 Mixed interventions or unclear	0		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29 Severe visual impairment	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30 Cerebral palsy (CP)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31 Manual removal of placenta (denominator = vaginal births)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32 Prolonged third stage (>30 minutes) (denominator = vaginal births)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33 Blood transfusion for mother Show forest plot	1	1176	Risk Ratio (M‐H, Random, 95% CI)	0.67 [0.36, 1.24]

33.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.4 DCC 1‐2 mins and baby held low	1	1176	Risk Ratio (M‐H, Random, 95% CI)	0.67 [0.36, 1.24]
33.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34 Postpartum infection in mother	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35 Rhesus isoimmunisation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
36 Psychological well being in mother	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.1 DCC < 1 min and baby level with uterus	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.2 DCC < 1 min and baby held low	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.3 DCC 1‐2 mins and baby level with uterus	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.4 DCC 1‐2 mins and baby held low	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.5 DCC > 2 mins and baby level with uterus	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.6 DCC > 2 mins and baby held low	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.7 Mixed interventions or unclear	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37 Bonding	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.1 DCC < 1 min and baby level with uterus	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.2 DCC < 1 min and baby held low	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.3 DCC 1‐2 mins and baby level with uterus	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.4 DCC 1‐2 mins and baby held low	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.5 DCC > 2 mins and baby level with uterus	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.6 DCC > 2 mins and baby held low	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.7 Mixed interventions or unclear	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
38 Breastfeeding initiation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39 Fully breastfed or mixed feeding at infant discharge Show forest plot	1	94	Risk Ratio (M‐H, Random, 95% CI)	1.11 [1.00, 1.23]

39.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.5 DCC > 2 mins and baby level with uterus	1	94	Risk Ratio (M‐H, Random, 95% CI)	1.11 [1.00, 1.23]
39.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40 Maternal anxiety	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
41 Mothers' views	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.1 DCC < 1 min and baby level with uterus	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.2 DCC < 1 min and baby held low	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.3 DCC 1‐2 mins and baby level with uterus	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.4 DCC 1‐2 mins and baby held low	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.5 DCC > 2 mins and baby level with uterus	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.6 DCC > 2 mins and baby held low	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.7 Mixed interventions or unclear	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
42 Neurosensory disability at 7 months (Bailey's MDI < 70) ‐ not prespecified Show forest plot	2	73	Risk Ratio (M‐H, Random, 95% CI)	1.64 [0.66, 4.09]

42.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
42.2 DCC < 1 min and baby held low	2	73	Risk Ratio (M‐H, Random, 95% CI)	1.64 [0.66, 4.09]
42.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
42.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
42.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
42.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
42.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 2. DCC with immediate neonatal care after cord clamping vs ECC (subgroup analysis by type of intervention)

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Comparison 3. DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death of baby (up to discharge) Show forest plot	1	270	Risk Ratio (M‐H, Random, 95% CI)	0.47 [0.20, 1.11]

1.1 < 32‐34 weeks gestation	1	270	Risk Ratio (M‐H, Random, 95% CI)	0.47 [0.20, 1.11]
1.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
1.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2 Death or neurodevelopmental impairment at age two to three years Show forest plot	1	218	Risk Ratio (M‐H, Random, 95% CI)	0.61 [0.39, 0.96]

2.1 < 32‐34 weeks gestation	1	218	Risk Ratio (M‐H, Random, 95% CI)	0.61 [0.39, 0.96]
2.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3 Severe intraventricular haemorrhage (IVH grades 3, 4) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.84 [0.29, 2.45]

3.1 < 32‐34 weeks gestation	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.84 [0.29, 2.45]
3.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4 Intraventricular haemorrhage (IVH, all grades) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.90 [0.64, 1.26]

4.1 < 32‐34 weeks gestation	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.90 [0.64, 1.26]
4.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5 Periventricular leukomalacia (PVL) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.86 [0.32, 2.31]

5.1 < 32‐34 weeks gestation	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.86 [0.32, 2.31]
5.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation) Show forest plot	1	249	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.66, 1.37]

6.1 < 32‐34 weeks gestation	1	249	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.66, 1.37]
6.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7 Maternal blood loss of 500 mL or greater Show forest plot	1	254	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.72, 1.22]

7.1 < 32‐34 weeks gestation	1	254	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.72, 1.22]
7.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8 Intraventricular haemorrhage (IVH, grades 1 & 2) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.91 [0.63, 1.33]

8.1 < 32‐34 weeks gestation	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.91 [0.63, 1.33]
8.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9 Necrotising enterocolitis (NEC) confirmed by X‐ray or laparotomy) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	1.58 [0.53, 4.69]

9.1 < 32‐34 weeks gestation	1	266	Risk Ratio (M‐H, Random, 95% CI)	1.58 [0.53, 4.69]
9.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10 Respiratory Distress Syndrome (RDS)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11 Respiratory support (ventilator or CPAP) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.96 [0.84, 1.09]

11.1 < 32‐34 weeks gestation	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.96 [0.84, 1.09]
11.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
12 Duration of respiratory support	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.1 < 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
13 Surfactant treatment (for severe RDS)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14 Treatment for Patent Ductus Arteriosus (PDA) (medical and/or surgical) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.56, 1.74]

14.1 < 32‐34 weeks gestation	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.56, 1.74]
14.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15 Treatment for Retinopathy of Prematurity (RoP) Show forest plot	1	249	Risk Ratio (M‐H, Random, 95% CI)	0.93 [0.28, 3.13]

15.1 < 32‐34 weeks gestation	1	249	Risk Ratio (M‐H, Random, 95% CI)	0.93 [0.28, 3.13]
15.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16 Hyperbilirubinemia (treated by phototherapy) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	1.01 [0.94, 1.09]

16.1 < 32‐34 weeks gestation	1	266	Risk Ratio (M‐H, Random, 95% CI)	1.01 [0.94, 1.09]
16.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17 Inotropics for low blood pressure	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18 Low Apgar as defined by trialists (generally < 8 at 5 mins)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19 Blood transfusion in infant Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.91 [0.71, 1.17]

19.1 < 32‐34 weeks gestation	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.91 [0.71, 1.17]
19.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
20 Volume of blood transfused (mL)	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.1 < 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
21 Late sepsis (after 3 days or as defined by trialists) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.72, 1.09]

21.1 < 32‐34 weeks gestation	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.72, 1.09]
21.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22 Hydrocephalus Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.14, 6.89]

22.1 < 32‐34 weeks gestation	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.14, 6.89]
22.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23 Temperature < 36.0^oC within 1 hour of birth Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	1.20 [0.61, 2.33]

23.1 < 32‐34 weeks gestation	1	266	Risk Ratio (M‐H, Random, 95% CI)	1.20 [0.61, 2.33]
23.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
24 Hb within 1st 24 hour of birth (g/dL)	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.1 < 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25 Mean arterial blood pressure (subgrouped by time after birth)	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.1 < 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.2 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.3 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26 Length of infant stay in NICU	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.1 < 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
27 Home oxygen	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28 Neurodevelopmental impairment at age two to three years Show forest plot	1	218	Risk Ratio (M‐H, Random, 95% CI)	0.75 [0.41, 1.39]

28.1 < 32‐34 weeks gestation	1	218	Risk Ratio (M‐H, Random, 95% CI)	0.75 [0.41, 1.39]
28.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29 Severe visual impairment	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30 Cerebral palsy (CP)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31 Manual removal of placenta (denominator = vaginal births) Show forest plot	1	105	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.32, 3.04]

31.1 < 32‐34 weeks gestation	1	105	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.32, 3.04]
31.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32 Prolonged third stage (>30 minutes) (denominator = vaginal births) Show forest plot	1	105	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.24, 2.64]

32.1 < 32‐34 weeks gestation	1	105	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.24, 2.64]
32.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33 Blood transfusion for mother Show forest plot	1	254	Risk Ratio (M‐H, Random, 95% CI)	1.59 [0.39, 6.51]

33.1 < 32‐34 weeks gestation	1	254	Risk Ratio (M‐H, Random, 95% CI)	1.59 [0.39, 6.51]
33.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34 Postpartum infection in mother Show forest plot	1	254	Risk Ratio (M‐H, Random, 95% CI)	1.12 [0.73, 1.72]

34.1 < 32‐34 weeks gestation	1	254	Risk Ratio (M‐H, Random, 95% CI)	1.12 [0.73, 1.72]
34.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35 Rhesus isoimmunisation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
36 Psychological well being in mother	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.1 < 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.2 > 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.3 Mixed gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37 Bonding	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.1 < 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.2 > 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.3 Mixed gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
38 Breastfeeding initiation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39 Fully breastfed or mixed feeding at infant discharge Show forest plot	1	248	Risk Ratio (M‐H, Random, 95% CI)	0.98 [0.79, 1.22]

39.1 < 32‐34 weeks gestation	1	248	Risk Ratio (M‐H, Random, 95% CI)	0.98 [0.79, 1.22]
39.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40 Maternal anxiety	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
41 Mothers' views	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.1 < 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.2 > 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.3 Mixed gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 3. DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by gestation)

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Comparison 4. DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death of baby (up to discharge) Show forest plot	1	270	Risk Ratio (M‐H, Random, 95% CI)	0.47 [0.20, 1.11]

1.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
1.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
1.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
1.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
1.5 DCC at > 2 mins with baby level with uterus	1	270	Risk Ratio (M‐H, Random, 95% CI)	0.47 [0.20, 1.11]
1.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
1.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2 Death or neurodevelopmental impairment at age two to three years Show forest plot	1	218	Risk Ratio (M‐H, Random, 95% CI)	0.61 [0.39, 0.96]

2.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.5 DCC at > 2 mins with baby level with uterus	1	218	Risk Ratio (M‐H, Random, 95% CI)	0.61 [0.39, 0.96]
2.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3 Severe intraventricular haemorrhage (IVH grades 3, 4) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.84 [0.29, 2.45]

3.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.5 DCC at > 2 mins with baby level with uterus	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.84 [0.29, 2.45]
3.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4 Intraventricular haemorrhage (IVH, all grades) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.90 [0.64, 1.26]

4.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.5 DCC at > 2 mins with baby level with uterus	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.90 [0.64, 1.26]
4.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5 Periventricular leukomalacia (PVL) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.86 [0.32, 2.31]

5.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.5 DCC at > 2 mins with baby level with uterus	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.86 [0.32, 2.31]
5.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation) Show forest plot	1	249	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.66, 1.37]

6.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.5 DCC at > 2 mins with baby level with uterus	1	249	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.66, 1.37]
6.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7 Maternal blood loss of 500 mL or greater Show forest plot	1	254	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.72, 1.22]

7.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.5 DCC at > 2 mins with baby level with uterus	1	254	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.72, 1.22]
7.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8 Intraventricular haemorrhage (IVH, grades 1 & 2) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.91 [0.63, 1.33]

8.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.5 DCC at > 2 mins with baby level with uterus	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.91 [0.63, 1.33]
8.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9 Necrotising enterocolitis (NEC) confirmed by X‐ray or laparotomy) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	1.58 [0.53, 4.69]

9.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.5 DCC at > 2 mins with baby level with uterus	1	266	Risk Ratio (M‐H, Random, 95% CI)	1.58 [0.53, 4.69]
9.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10 Respiratory Distress Syndrome (RDS)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.5 DCC at > 2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.8 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11 Respiratory support (ventilator or CPAP) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.96 [0.84, 1.09]

11.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.5 DCC at > 2 mins with baby level with uterus	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.96 [0.84, 1.09]
11.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
12 Duration of respiratory support	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
13 Surfactant treatment (for severe RDS)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.5 DCC at > 2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14 Treatment for Patent Ductus Arteriosus (PDA) (medical and/or surgical) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.56, 1.74]

14.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.5 DCC at > 2 mins with baby level with uterus	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.56, 1.74]
14.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15 Treatment for Retinopathy of Prematurity (RoP) Show forest plot	1	249	Risk Ratio (M‐H, Random, 95% CI)	0.93 [0.28, 3.13]

15.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.5 DCC at > 2 mins with baby level with uterus	1	249	Risk Ratio (M‐H, Random, 95% CI)	0.93 [0.28, 3.13]
15.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16 Hyperbilirubinemia (treated by phototherapy) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	1.01 [0.94, 1.09]

16.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.5 DCC at > 2 mins with baby level with uterus	1	266	Risk Ratio (M‐H, Random, 95% CI)	1.01 [0.94, 1.09]
16.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17 Inotropics for low blood pressure	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.5 DCC at > 2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18 Low Apgar as defined by trialists (generally < 8 at 5 mins)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.5 DCC at > 2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19 Blood transfusion in infant Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.91 [0.71, 1.17]

19.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.5 DCC at > 2 mins with baby level with uterus	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.91 [0.71, 1.17]
19.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
20 Volume of blood transfused	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
21 Late sepsis (after 3 days or as defined by trialists) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.72, 1.09]

21.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.5 DCC at > 2 mins with baby level with uterus	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.72, 1.09]
21.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22 Hydrocephalus Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.14, 6.89]

22.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.5 DCC at > 2 mins with baby level with uterus	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.14, 6.89]
22.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23 Temperature < 36.0^oC within 1 hour of birth Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	1.20 [0.61, 2.33]

23.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.5 DCC at > 2 mins with baby level with uterus	1	266	Risk Ratio (M‐H, Random, 95% CI)	1.20 [0.61, 2.33]
23.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
24 Hb within 1st 24 hour of birth (g/dL)	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25 Mean arterial blood pressure (subgrouped by time after birth)	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26 Length of infant stay in NICU	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
27 Home oxygen	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.5 DCC at > 2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28 Neurodevelopmental impairment at age two to three years Show forest plot	1	194	Risk Ratio (M‐H, Random, 95% CI)	0.33 [0.06, 1.64]

28.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.5 DCC at > 2 mins with baby level with uterus	1	194	Risk Ratio (M‐H, Random, 95% CI)	0.33 [0.06, 1.64]
28.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29 Severe visual impairment	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.5 DCC at > 2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30 Cerebral palsy (CP)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.5 DCC at > 2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31 Manual removal of placenta (denominator = vaginal births) Show forest plot	1	105	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.32, 3.04]

31.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.5 DCC at > 2 mins with baby level with uterus	1	105	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.32, 3.04]
31.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32 Prolonged third stage (>30 minutes) (denominator = vaginal births) Show forest plot	1	105	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.24, 2.64]

32.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.5 DCC at > 2 mins with baby level with uterus	1	105	Risk Ratio (M‐H, Random, 95% CI)	0.79 [0.24, 2.64]
32.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33 Blood transfusion for mother Show forest plot	1	254	Risk Ratio (M‐H, Random, 95% CI)	1.59 [0.39, 6.51]

33.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.5 DCC at > 2 mins with baby level with uterus	1	254	Risk Ratio (M‐H, Random, 95% CI)	1.59 [0.39, 6.51]
33.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34 Postpartum infection in mother Show forest plot	1	254	Risk Ratio (M‐H, Random, 95% CI)	1.12 [0.73, 1.72]

34.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.5 DCC at > 2 mins with baby level with uterus	1	254	Risk Ratio (M‐H, Random, 95% CI)	1.12 [0.73, 1.72]
34.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35 Rhesus isoimmunisation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.5 DCC at > 2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
36 Psychological well being in mother	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37 Bonding	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
38 Breastfeeding initiation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.5 DCC at > 2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39 Fully breastfed or mixed feeding at infant discharge Show forest plot	1	248	Risk Ratio (M‐H, Random, 95% CI)	0.98 [0.79, 1.22]

39.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.5 DCC at > 2 mins with baby level with uterus	1	248	Risk Ratio (M‐H, Random, 95% CI)	0.98 [0.79, 1.22]
39.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40 Maternal anxiety	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.3 DCC at 1‐2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.4 DCC at 1‐2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.5 DCC at > 2 mins with baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.6 DCC at > 2 mins with baby low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
41 Mothers' views	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 4. DCC with immediate neonatal care with cord intact vs ECC (subgroup analysis by type of intervention)

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Comparison 5. DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death of baby (up to discharge) Show forest plot	3	322	Risk Ratio (M‐H, Random, 95% CI)	2.14 [0.93, 4.93]

1.1 < 32‐34 weeks gestation	3	322	Risk Ratio (M‐H, Random, 95% CI)	2.14 [0.93, 4.93]
1.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
1.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2 Death or neurodevelopmental impairment at age two to three years Show forest plot	2	195	Risk Ratio (M‐H, Random, 95% CI)	1.67 [0.78, 3.57]

2.1 < 32‐34 weeks gestation	2	195	Risk Ratio (M‐H, Random, 95% CI)	1.67 [0.78, 3.57]
2.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3 Severe intraventricular haemorrhage (IVH grades 3, 4) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	2.63 [0.11, 61.88]

3.1 < 32‐34 weeks gestation	1	58	Risk Ratio (M‐H, Random, 95% CI)	2.63 [0.11, 61.88]
3.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4 Intraventricular haemorrhage (IVH, all grades) Show forest plot	2	125	Risk Ratio (M‐H, Random, 95% CI)	1.32 [0.55, 3.17]

4.1 < 32‐34 weeks gestation	2	125	Risk Ratio (M‐H, Random, 95% CI)	1.32 [0.55, 3.17]
4.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5 Periventricular leukomalacia (PVL) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

5.1 < 32‐34 weeks gestation	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation) Show forest plot	2	125	Risk Ratio (M‐H, Random, 95% CI)	1.53 [0.43, 5.48]

6.1 < 32‐34 weeks gestation	2	125	Risk Ratio (M‐H, Random, 95% CI)	1.53 [0.43, 5.48]
6.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7 Maternal blood loss of 500 mL or greater	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8 Intraventricular haemorrhage (IVH, grades 1 & 2) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	1.74 [0.48, 6.30]

8.1 < 32‐34 weeks gestation	1	58	Risk Ratio (M‐H, Random, 95% CI)	1.74 [0.48, 6.30]
8.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9 Necrotising enterocolitis (NEC) confirmed by X‐ray or laparotomy) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	3.48 [0.41, 29.31]

9.1 < 32‐34 weeks gestation	1	58	Risk Ratio (M‐H, Random, 95% CI)	3.48 [0.41, 29.31]
9.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10 Respiratory Distress Syndrome (RDS)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11 Respiratory support (ventilator or CPAP)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
12 Duration of respiratory support (days) Show forest plot	1	67	Mean Difference (IV, Random, 95% CI)	1.80 [‐2.01, 5.61]

12.1 < 32‐34 weeks gestation	1	67	Mean Difference (IV, Random, 95% CI)	1.80 [‐2.01, 5.61]
12.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
13 Surfactant treatment (for severe RDS) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	1.19 [0.66, 2.13]

13.1 < 32‐34 weeks gestation	1	58	Risk Ratio (M‐H, Random, 95% CI)	1.19 [0.66, 2.13]
13.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14 Treatment for Patent Ductus Arteriosus (PDA) (medical and/or surgical)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15 Treatment for Retinopathy of Prematurity (RoP) Show forest plot	1	67	Risk Ratio (M‐H, Random, 95% CI)	0.73 [0.23, 2.35]

15.1 < 32‐34 weeks gestation	1	67	Risk Ratio (M‐H, Random, 95% CI)	0.73 [0.23, 2.35]
15.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16 Hyperbilirubinemia (treated by phototherapy)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17 Inotropics for low blood pressure	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18 Low Apgar as defined by trialists (generally < 8 at 5 mins)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19 Blood transfusion in infant Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.77 [0.48, 1.22]

19.1 < 32‐34 weeks gestation	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.77 [0.48, 1.22]
19.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
20 Volume of blood transfused	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.1 < 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
21 Late sepsis (after 3 days or as defined by trialists) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.06, 13.27]

21.1 < 32‐34 weeks gestation	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.06, 13.27]
21.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22 Hydrocephalus Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

22.1 < 32‐34 weeks gestation	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23 Temperature < 36.0oC within 1 hour of birth	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
24 Hb within 1^st 24 hour of birth (g/dL) Show forest plot	1	58	Mean Difference (IV, Random, 95% CI)	‐0.20 [‐1.57, 1.17]

24.1 < 32‐34 weeks gestation	1	58	Mean Difference (IV, Random, 95% CI)	‐0.20 [‐1.57, 1.17]
24.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25 Mean arterial blood pressure (subgrouped by time after birth)	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.1 < 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26 Length of infant stay in NICU	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.1 < 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
27 Home oxygen Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.29 [0.01, 6.88]

27.1 < 32‐34 weeks gestation	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.29 [0.01, 6.88]
27.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28 Neurodevelopmental impairment at age two to three years Show forest plot	2	174	Risk Ratio (M‐H, Random, 95% CI)	1.18 [0.04, 32.88]

28.1 < 32‐34 weeks gestation	2	174	Risk Ratio (M‐H, Random, 95% CI)	1.18 [0.04, 32.88]
28.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29 Severe visual impairment Show forest plot	1	39	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

29.1 < 32‐34 weeks gestation	1	39	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30 Cerebral palsy (CP) Show forest plot	1	39	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

30.1 < 32‐34 weeks gestation	1	39	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31 Manual removal of placenta (denominator = vaginal births)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32 Prolonged third stage (> 30 minutes) (denominator = vaginal births)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33 Blood transfusion for mother	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34 Postpartum infection in mother	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35 Rhesus isoimmunisation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
36 Psychological well being in mother	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.1 < 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.2 > 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.3 Mixed gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37 Bonding	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.1 < 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.2 > 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.3 Mixed gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
38 Breastfeeding initiation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39 Fully breastfed or mixed feeding at infant discharge	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40 Maternal anxiety	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
41 Mothers' views	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.1 < 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.2 > 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.3 Mixed gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 5. DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by gestation)

Ir a la tabla de la revisión

Comparison 6. DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death of baby (up to discharge) Show forest plot	3	322	Risk Ratio (M‐H, Random, 95% CI)	2.14 [0.93, 4.93]

1.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
1.2 DCC < 1 min and baby held low	3	322	Risk Ratio (M‐H, Random, 95% CI)	2.14 [0.93, 4.93]
1.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
1.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
1.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
1.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
1.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2 Death or neurodevelopmental impairment at age two to three years Show forest plot	2	195	Risk Ratio (M‐H, Random, 95% CI)	1.67 [0.78, 3.57]

2.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.2 DCC < 1 min and baby held low	2	195	Risk Ratio (M‐H, Random, 95% CI)	1.67 [0.78, 3.57]
2.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3 Severe intraventricular haemorrhage (IVH grades 3, 4) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	2.63 [0.11, 61.88]

3.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.2 DCC < 1 min and baby held low	1	58	Risk Ratio (M‐H, Random, 95% CI)	2.63 [0.11, 61.88]
3.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4 Intraventricular haemorrhage (IVH, all grades) Show forest plot	2	125	Risk Ratio (M‐H, Random, 95% CI)	1.32 [0.55, 3.17]

4.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.2 DCC < 1 min and baby held low	2	125	Risk Ratio (M‐H, Random, 95% CI)	1.32 [0.55, 3.17]
4.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5 Periventricular leukomalacia (PVL) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

5.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.2 DCC < 1 min and baby held low	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation) Show forest plot	2	125	Risk Ratio (M‐H, Random, 95% CI)	1.53 [0.43, 5.48]

6.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.2 DCC < 1 min and baby held low	2	125	Risk Ratio (M‐H, Random, 95% CI)	1.53 [0.43, 5.48]
6.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7 Maternal blood loss of 500 mL or greater	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8 Intraventricular haemorrhage (IVH, grades 1 & 2) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	1.74 [0.48, 6.30]

8.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.2 DCC < 1 min and baby held low	1	58	Risk Ratio (M‐H, Random, 95% CI)	1.74 [0.48, 6.30]
8.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9 Necrotising enterocolitis (NEC) confirmed by X ray or laparotomy)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10 Respiratory Distress Syndrome (RDS)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11 Respiratory support (ventilator or CPAP)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
12 Duration of respiratory support (days) Show forest plot	1	67	Mean Difference (IV, Random, 95% CI)	1.80 [‐2.01, 5.61]

12.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.2 DCC < 1 min and baby held low	1	67	Mean Difference (IV, Random, 95% CI)	1.80 [‐2.01, 5.61]
12.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
13 Surfactant treatment (for severe RDS) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	1.19 [0.66, 2.13]

13.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.2 DCC < 1 min and baby held low	1	58	Risk Ratio (M‐H, Random, 95% CI)	1.19 [0.66, 2.13]
13.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14 Treatment for Patent Ductus Arteriosus (PDA) (medical and/or surgical)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15 Treatment for Retinopathy of Prematurity (RoP) Show forest plot	1	67	Risk Ratio (M‐H, Random, 95% CI)	0.73 [0.23, 2.35]

15.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.2 DCC < 1 min and baby held low	1	67	Risk Ratio (M‐H, Random, 95% CI)	0.73 [0.23, 2.35]
15.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16 Hyperbilirubinemia (treated by phototherapy)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17 Inotropics for low blood pressure	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18 Low Apgar as defined by trialists (generally < 8 at 5 mins)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19 Blood transfusion in infant Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.77 [0.48, 1.22]

19.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.2 DCC < 1 min and baby held low	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.77 [0.48, 1.22]
19.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
20 Volume of blood transfused	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
21 Late sepsis (after 3 days or as defined by trialists) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.06, 13.27]

21.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.2 DCC < 1 min and baby held low	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.06, 13.27]
21.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22 Hydrocephalus Show forest plot	2	116	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

22.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.2 DCC < 1 min and baby held low	2	116	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23 Temperature < 36.0oC within 1 hour of birth	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
24 Hb within 1^st 24 hour of birth (g/dL) Show forest plot	1	58	Mean Difference (IV, Random, 95% CI)	‐0.20 [‐1.57, 1.17]

24.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.2 DCC < 1 min and baby held low	1	58	Mean Difference (IV, Random, 95% CI)	‐0.20 [‐1.57, 1.17]
24.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
24.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25 Mean arterial blood pressure (subgrouped by time after birth)	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26 Length of infant stay in NICU	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
27 Home oxygen Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.29 [0.01, 6.88]

27.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.2 DCC < 1 min and baby held low	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.29 [0.01, 6.88]
27.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28 Neurodevelopmental impairment at age two to three years Show forest plot	2	174	Risk Ratio (M‐H, Random, 95% CI)	1.18 [0.04, 32.88]

28.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.2 DCC < 1 min and baby held low	2	174	Risk Ratio (M‐H, Random, 95% CI)	1.18 [0.04, 32.88]
28.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29 Severe visual impairment Show forest plot	1	39	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

29.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.2 DCC < 1 min and baby held low	1	39	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30 Cerebral palsy (CP) Show forest plot	1	39	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

30.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.2 DCC < 1 min and baby held low	1	39	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31 Manual removal of placenta (denominator = vaginal births)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32 Prolonged third stage (>30 minutes) (denominator = vaginal births)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33 Blood transfusion for mother	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34 Postpartum infection in mother	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35 Rhesus isoimmunisation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
36 Psychological well being in mother	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37 Bonding	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
38 Breastfeeding initiation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39 Fully breastfed or mixed feeding at infant discharge	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40 Maternal anxiety	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.1 DCC < 1 min and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.2 DCC < 1 min and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.3 DCC 1‐2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.4 DCC 1‐2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.5 DCC > 2 mins and baby level with uterus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.6 DCC > 2 mins and baby held low	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.7 Mixed interventions or unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
41 Mothers' views	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.1 DCC < 1 min and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.2 DCC < 1 min and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.3 DCC 1‐2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.4 DCC 1‐2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.5 DCC > 2 mins and baby level with uterus	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.6 DCC > 2 mins and baby held low	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.7 Mixed interventions or unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 6. DCC with immediate neonatal care after cord clamping vs UCM (subgroup analysis by type of intervention)

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Comparison 7. UCM vs ECC (subgroup analysis by gestation)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death of baby (up to discharge) Show forest plot	9	931	Risk Ratio (M‐H, Random, 95% CI)	0.81 [0.47, 1.41]

1.1 < 32‐34 weeks gestation	8	731	Risk Ratio (M‐H, Random, 95% CI)	0.70 [0.38, 1.29]
1.2 > 32‐34 weeks gestation	1	200	Risk Ratio (M‐H, Random, 95% CI)	1.5 [0.44, 5.15]
1.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2 Death or neurodevelopmental impairment at age two to three years	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3 Severe intraventricular haemorrhage (IVH grades 3, 4) Show forest plot	6	618	Risk Ratio (M‐H, Random, 95% CI)	0.75 [0.39, 1.45]

3.1 < 32‐34 weeks gestation	6	618	Risk Ratio (M‐H, Random, 95% CI)	0.75 [0.39, 1.45]
3.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4 Intraventricular haemorrhage (IVH, all grades) Show forest plot	8	716	Risk Ratio (M‐H, Random, 95% CI)	0.85 [0.62, 1.18]

4.1 < 32‐34 weeks gestation	8	716	Risk Ratio (M‐H, Random, 95% CI)	0.85 [0.62, 1.18]
4.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5 Periventricular leukomalacia (PVL) Show forest plot	3	315	Risk Ratio (M‐H, Random, 95% CI)	0.63 [0.15, 2.63]

5.1 < 32‐34 weeks gestation	3	315	Risk Ratio (M‐H, Random, 95% CI)	0.63 [0.15, 2.63]
5.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation) Show forest plot	7	682	Risk Ratio (M‐H, Random, 95% CI)	1.03 [0.64, 1.66]

6.1 < 32‐34 weeks gestation	7	682	Risk Ratio (M‐H, Random, 95% CI)	1.03 [0.64, 1.66]
6.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7 Maternal blood loss of 500 mL or greater Show forest plot	1	200	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

7.1 < 32‐34 weeks gestation	1	200	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8 Intraventricular haemorrhage (IVH, grades 1 & 2) Show forest plot	6	618	Risk Ratio (M‐H, Random, 95% CI)	0.74 [0.44, 1.25]

8.1 < 32‐34 weeks gestation	6	618	Risk Ratio (M‐H, Random, 95% CI)	0.74 [0.44, 1.25]
8.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9 Necrotising enterocolitis (NEC) confirmed by X‐ray or laparotomy) Show forest plot	6	616	Risk Ratio (M‐H, Random, 95% CI)	0.75 [0.41, 1.38]

9.1 < 32‐34 weeks gestation	6	616	Risk Ratio (M‐H, Random, 95% CI)	0.75 [0.41, 1.38]
9.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10 Respiratory Distress Syndrome (RDS) Show forest plot	4	515	Risk Ratio (M‐H, Random, 95% CI)	1.05 [0.83, 1.32]

10.1 < 32‐34 weeks gestation	3	315	Risk Ratio (M‐H, Random, 95% CI)	1.00 [0.95, 1.05]
10.2 > 32‐34 weeks gestation	1	200	Risk Ratio (M‐H, Random, 95% CI)	2.0 [0.71, 5.64]
10.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11 Respiratory support (ventilator or CPAP) Show forest plot	2	129	Risk Ratio (M‐H, Random, 95% CI)	1.04 [0.74, 1.47]

11.1 < 32‐34 weeks gestation	2	129	Risk Ratio (M‐H, Random, 95% CI)	1.04 [0.74, 1.47]
11.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
12 Duration of respiratory support (days) Show forest plot	1	199	Mean Difference (IV, Random, 95% CI)	2.80 [‐9.78, 15.38]

12.1 < 32‐34 weeks gestation	1	199	Mean Difference (IV, Random, 95% CI)	2.80 [‐9.78, 15.38]
12.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
13 Surfactant treatment (for severe RDS) Show forest plot	5	433	Risk Ratio (M‐H, Random, 95% CI)	1.13 [0.81, 1.58]

13.1 < 32‐34 weeks gestation	5	433	Risk Ratio (M‐H, Random, 95% CI)	1.13 [0.81, 1.58]
13.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14 Treatment for Patent Ductus Arteriosus (PDA) (medical and/or surgical) Show forest plot	5	411	Risk Ratio (M‐H, Random, 95% CI)	1.00 [0.73, 1.38]

14.1 < 32‐34 weeks gestation	5	411	Risk Ratio (M‐H, Random, 95% CI)	1.00 [0.73, 1.38]
14.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15 Treatment for Retinopathy of Prematurity (RoP) Show forest plot	5	274	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.76, 1.19]

15.1 < 32‐34 weeks gestation	5	274	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.76, 1.19]
15.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16 Hyperbilirubinemia (treated by phototherapy) Show forest plot	3	475	Risk Ratio (M‐H, Random, 95% CI)	1.39 [0.73, 2.63]

16.1 < 32‐34 weeks gestation	2	275	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.86, 1.06]
16.2 > 32‐34 weeks gestation	1	200	Risk Ratio (M‐H, Random, 95% CI)	3.67 [1.85, 7.26]
16.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17 Inotropics for low blood pressure Show forest plot	3	300	Risk Ratio (M‐H, Random, 95% CI)	0.61 [0.36, 1.04]

17.1 < 32‐34 weeks gestation	3	300	Risk Ratio (M‐H, Random, 95% CI)	0.61 [0.36, 1.04]
17.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18 Low Apgar as defined by trialists (generally < 8 at 5 mins) Show forest plot	2	398	Risk Ratio (M‐H, Random, 95% CI)	1.03 [0.67, 1.60]

18.1 < 32‐34 weeks gestation	2	398	Risk Ratio (M‐H, Random, 95% CI)	1.03 [0.67, 1.60]
18.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19 Blood transfusion in infant Show forest plot	6	567	Risk Ratio (M‐H, Random, 95% CI)	0.71 [0.57, 0.89]

19.1 < 32‐34 weeks gestation	6	567	Risk Ratio (M‐H, Random, 95% CI)	0.71 [0.57, 0.89]
19.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
20 Volume of blood transfused (mL) Show forest plot	1	199	Mean Difference (IV, Random, 95% CI)	‐19.0 [‐39.61, 1.61]

20.1 < 32‐34 weeks gestation	1	199	Mean Difference (IV, Random, 95% CI)	‐19.0 [‐39.61, 1.61]
20.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
21 Late sepsis (after 3 days or as defined by trialists) Show forest plot	4	385	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.64, 1.19]

21.1 < 32‐34 weeks gestation	4	385	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.64, 1.19]
21.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22 Hydrocephalus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23 Temperature < 36.0oC within 1 hour of birth	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
24 Hb within 1^st 24 hour of birth (g/dL) Show forest plot	7	905	Mean Difference (IV, Random, 95% CI)	0.84 [0.54, 1.14]

24.1 < 32‐34 weeks gestation	6	705	Mean Difference (IV, Random, 95% CI)	0.87 [0.54, 1.20]
24.2 > 32‐34 weeks gestation	1	200	Mean Difference (IV, Random, 95% CI)	0.70 [0.00, 1.40]
24.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
25 Mean arterial blood pressure Show forest plot	2	408	Mean Difference (IV, Random, 95% CI)	0.38 [‐1.33, 2.09]

25.1 < 32‐34 weeks gestation	1	208	Mean Difference (IV, Random, 95% CI)	0.0 [‐2.17, 2.17]
25.2 > 32‐34 weeks gestation	1	200	Mean Difference (IV, Random, 95% CI)	1.0 [‐1.76, 3.76]
25.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26 Length of infant stay in NICU (in weeks) Show forest plot	1	199	Mean Difference (IV, Random, 95% CI)	5.30 [‐5.49, 16.09]

26.1 < 32‐34 weeks gestation	1	199	Mean Difference (IV, Random, 95% CI)	5.30 [‐5.49, 16.09]
26.2 > 32‐34 weeks gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.3 Mixed gestation	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
27 Home oxygen Show forest plot	1	199	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.38, 2.10]

27.1 < 32‐34 weeks gestation	1	199	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.38, 2.10]
27.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28 Neurodevelopmental impairment at age two to three years Show forest plot	2	187	Risk Ratio (M‐H, Random, 95% CI)	1.25 [0.49, 3.17]

28.1 < 32‐34 weeks gestation	2	187	Risk Ratio (M‐H, Random, 95% CI)	1.25 [0.49, 3.17]
28.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29 Severe visual impairment Show forest plot	1	125	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

29.1 < 32‐34 weeks gestation	1	125	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30 Cerebral palsy (CP) Show forest plot	2	286	Risk Ratio (M‐H, Random, 95% CI)	0.70 [0.05, 10.63]

30.1 < 32‐34 weeks gestation	2	286	Risk Ratio (M‐H, Random, 95% CI)	0.70 [0.05, 10.63]
30.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31 Manual removal of placenta (denominator = vaginal births)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32 Prolonged third stage (> 30 minutes) (denominator = vaginal births)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33 Blood transfusion for mother	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34 Postpartum infection in mother	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35 Rhesus isoimmunisation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
36 Psychological well being in mother	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.1 < 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.2 > 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.3 Mixed gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37 Bonding	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.1 < 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.2 > 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.3 Mixed gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
38 Breastfeeding initiation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39 Fully breastfed or mixed feeding at infant discharge	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40 Maternal anxiety	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.1 < 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.2 > 32‐34 weeks gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.3 Mixed gestation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
41 Mothers' views	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.1 < 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.2 > 32‐34 weeks gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.3 Mixed gestation	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 7. UCM vs ECC (subgroup analysis by gestation)

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Comparison 8. UCM vs ECC (subgroup analysis by type of intervention)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death of baby (up to discharge) Show forest plot	9	931	Risk Ratio (M‐H, Random, 95% CI)	0.81 [0.47, 1.41]

1.1 UCM with cord intact	7	705	Risk Ratio (M‐H, Random, 95% CI)	0.72 [0.38, 1.34]
1.2 UCM with cord cut	1	200	Risk Ratio (M‐H, Random, 95% CI)	1.5 [0.44, 5.15]
1.3 Unclear	1	26	Risk Ratio (M‐H, Random, 95% CI)	0.33 [0.01, 7.50]
2 Death or neurodevelopmental impairment at age two to three years	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.1 UCM with cord intact	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
2.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3 Severe intraventricular haemorrhage (IVH grades 3, 4) Show forest plot	6	618	Risk Ratio (M‐H, Random, 95% CI)	0.75 [0.39, 1.45]

3.1 UCM with cord intact	6	618	Risk Ratio (M‐H, Random, 95% CI)	0.75 [0.39, 1.45]
3.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4 Intraventricular haemorrhage (IVH, all grades) Show forest plot	8	716	Risk Ratio (M‐H, Random, 95% CI)	0.85 [0.62, 1.18]

4.1 UCM with cord intact	7	691	Risk Ratio (M‐H, Random, 95% CI)	0.84 [0.58, 1.21]
4.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
4.3 Unclear	1	25	Risk Ratio (M‐H, Random, 95% CI)	0.92 [0.35, 2.41]
5 Periventricular leukomalacia (PVL) Show forest plot	3	315	Risk Ratio (M‐H, Random, 95% CI)	0.63 [0.15, 2.63]

5.1 UCM with cord intact	3	315	Risk Ratio (M‐H, Random, 95% CI)	0.63 [0.15, 2.63]
5.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation) Show forest plot	7	682	Risk Ratio (M‐H, Random, 95% CI)	1.03 [0.64, 1.66]

6.1 UCM with cord intact	7	682	Risk Ratio (M‐H, Random, 95% CI)	1.03 [0.64, 1.66]
6.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
6.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7 Maternal blood loss of 500 mL or greater Show forest plot	1	200	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

7.1 UCM with cord intact	1	200	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
7.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8 Intraventricular haemorrhage (IVH, grades 1 & 2) Show forest plot	6	618	Risk Ratio (M‐H, Random, 95% CI)	0.74 [0.44, 1.25]

8.1 UCM with cord intact	6	618	Risk Ratio (M‐H, Random, 95% CI)	0.74 [0.44, 1.25]
8.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
8.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9 Necrotising enterocolitis (NEC) confirmed by X‐ray or laparotomy) Show forest plot	6	616	Risk Ratio (M‐H, Random, 95% CI)	0.75 [0.41, 1.38]

9.1 UCM with cord intact	5	591	Risk Ratio (M‐H, Random, 95% CI)	0.75 [0.41, 1.38]
9.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
9.3 Unclear	1	25	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
10 Respiratory Distress Syndrome (RDS) Show forest plot	4	515	Risk Ratio (M‐H, Random, 95% CI)	1.05 [0.83, 1.32]

10.1 UCM with cord intact	3	315	Risk Ratio (M‐H, Random, 95% CI)	1.00 [0.95, 1.05]
10.2 UCM with cord cut	1	200	Risk Ratio (M‐H, Random, 95% CI)	2.0 [0.71, 5.64]
10.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11 Respiratory support (ventilator or CPAP) Show forest plot	2	129	Risk Ratio (M‐H, Random, 95% CI)	1.04 [0.74, 1.47]

11.1 UCM with cord intact	2	129	Risk Ratio (M‐H, Random, 95% CI)	1.04 [0.74, 1.47]
11.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
11.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
12 Duration of respiratory support (days) Show forest plot	1	199	Mean Difference (IV, Random, 95% CI)	2.80 [‐9.78, 15.38]

12.1 UCM with cord intact	1	199	Mean Difference (IV, Random, 95% CI)	2.80 [‐9.78, 15.38]
12.2 UCM with cord cut	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
12.3 Unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
13 Surfactant treatment (for severe RDS) Show forest plot	5	433	Risk Ratio (M‐H, Random, 95% CI)	1.13 [0.81, 1.58]

13.1 UCM with cord intact	5	433	Risk Ratio (M‐H, Random, 95% CI)	1.13 [0.81, 1.58]
13.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
13.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14 Treatment for Patent Ductus Arteriosus (PDA) (medical and/or surgical) Show forest plot	5	411	Risk Ratio (M‐H, Random, 95% CI)	1.00 [0.73, 1.38]

14.1 UCM with cord intact	5	411	Risk Ratio (M‐H, Random, 95% CI)	1.00 [0.73, 1.38]
14.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
14.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15 Treatment for Retinopathy of Prematurity (RoP) Show forest plot	5	274	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.76, 1.19]

15.1 UCM with cord intact	5	274	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.76, 1.19]
15.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
15.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
16 Hyperbilirubinemia (treated by phototherapy) Show forest plot	3	475	Risk Ratio (M‐H, Random, 95% CI)	1.39 [0.73, 2.63]

16.1 UCM with cord intact	2	275	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.86, 1.06]
16.2 UCM with cord cut	1	200	Risk Ratio (M‐H, Random, 95% CI)	3.67 [1.85, 7.26]
16.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17 Inotropics for low blood pressure Show forest plot	3	280	Risk Ratio (M‐H, Random, 95% CI)	0.63 [0.36, 1.09]

17.1 UCM with cord intact	3	280	Risk Ratio (M‐H, Random, 95% CI)	0.63 [0.36, 1.09]
17.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
17.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18 Low Apgar as defined by trialists (generally < 8 at 5 mins) Show forest plot	2	398	Risk Ratio (M‐H, Random, 95% CI)	1.03 [0.67, 1.60]

18.1 UCM with cord intact	2	398	Risk Ratio (M‐H, Random, 95% CI)	1.03 [0.67, 1.60]
18.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
18.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
19 Blood transfusion in infant (mL) Show forest plot	6	567	Risk Ratio (M‐H, Random, 95% CI)	0.67 [0.54, 0.84]

19.1 UCM with cord intact	5	413	Risk Ratio (M‐H, Random, 95% CI)	0.69 [0.51, 0.93]
19.2 UCM with cord cut	1	154	Risk Ratio (M‐H, Random, 95% CI)	0.62 [0.43, 0.90]
19.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
20 Volume of blood transfused Show forest plot	1	199	Mean Difference (IV, Random, 95% CI)	‐19.0 [‐39.61, 1.61]

20.1 UCM with cord intact	1	199	Mean Difference (IV, Random, 95% CI)	‐19.0 [‐39.61, 1.61]
20.2 UCM with cord cut	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
20.3 Unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
21 Late sepsis (after 3 days or as defined by trialists) Show forest plot	4	385	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.64, 1.19]

21.1 UCM with cord intact	4	385	Risk Ratio (M‐H, Random, 95% CI)	0.87 [0.64, 1.19]
21.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
21.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22 Hydrocephalus	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.1 UCM with cord intact	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
22.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23 Temperature < 36.0oC within 1 hour of birth	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.1 UCM with cord intact	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
23.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
24 Hb within 1^st 24 hour of birth (g/dL) Show forest plot	7	905	Mean Difference (IV, Random, 95% CI)	0.84 [0.54, 1.14]

24.1 UCM with cord intact	4	526	Mean Difference (IV, Random, 95% CI)	0.76 [0.36, 1.16]
24.2 UCM with cord cut	2	354	Mean Difference (IV, Random, 95% CI)	0.97 [0.48, 1.46]
24.3 Unclear	1	25	Mean Difference (IV, Random, 95% CI)	0.5 [‐1.33, 2.33]
25 Mean arterial blood pressure (subgrouped by time after birth) Show forest plot	2	408	Mean Difference (IV, Random, 95% CI)	0.38 [‐1.33, 2.09]

25.1 UCM with cord intact	1	208	Mean Difference (IV, Random, 95% CI)	0.0 [‐2.17, 2.17]
25.2 UCM with cord cut	1	200	Mean Difference (IV, Random, 95% CI)	1.0 [‐1.76, 3.76]
25.3 Unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26 Length of infant stay in NICU Show forest plot	1	199	Mean Difference (IV, Random, 95% CI)	5.30 [‐5.49, 16.09]

26.1 UCM with cord intact	1	199	Mean Difference (IV, Random, 95% CI)	5.30 [‐5.49, 16.09]
26.2 UCM with cord cut	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
26.3 Unclear	0	0	Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
27 Home oxygen Show forest plot	1	199	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.38, 2.10]

27.1 UCM with cord intact	1	199	Risk Ratio (M‐H, Random, 95% CI)	0.89 [0.38, 2.10]
27.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
27.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28 Neurodevelopmental impairment at age two to three years Show forest plot	2	187	Risk Ratio (M‐H, Random, 95% CI)	1.25 [0.49, 3.17]

28.1 UCM with cord intact	2	187	Risk Ratio (M‐H, Random, 95% CI)	1.25 [0.49, 3.17]
28.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
28.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29 Severe visual impairment Show forest plot	1	125	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

29.1 UCM with cord intact	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.2 UCM with cord cut	1	125	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
29.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
30 Cerebral palsy (CP) Show forest plot	2	286	Risk Ratio (M‐H, Random, 95% CI)	0.70 [0.05, 10.63]

30.1 UCM with cord intact	1	161	Risk Ratio (M‐H, Random, 95% CI)	2.65 [0.88, 7.97]
30.2 UCM with cord cut	1	125	Risk Ratio (M‐H, Random, 95% CI)	0.17 [0.04, 0.73]
30.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31 Manual removal of placenta (denominator = vaginal births)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.1 UCM with cord intact	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
31.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32 Prolonged third stage (>30 minutes) (denominator = vaginal births)	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.1 UCM with cord intact	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
32.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33 Blood transfusion for mother	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.1 UCM with cord intact	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
33.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34 Postpartum infection in mother	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.1 UCM with cord intact	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
34.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35 Rhesus isoimmunisation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.1 UCM with cord intact	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
35.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
36 Psychological well being in mother	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.1 UCM with cord intact	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.2 UCM with cord cut	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
36.3 Unclear	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37 Bonding	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.1 UCM with cord intact	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.2 UCM with cord cut	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
37.3 Unclear	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
38 Breastfeeding initiation	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.1 UCM with cord intact	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
38.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39 Fully or mixed feeding at infant discharge	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.1 UCM with cord intact	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
39.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40 Maternal anxiety	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.1 UCM with cord intact	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.2 UCM with cord cut	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
40.3 Unclear	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
41 Mothers' views	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.1 UCM with cord intact	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.2 UCM with cord cut	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
41.3 Unclear	0	0	Std. Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 8. UCM vs ECC (subgroup analysis by type of intervention)

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Comparison 9. DCC with immediate neonatal care after cord clamping vs ECC (low risk of bias)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death of baby (up to discharge) Show forest plot	5	1804	Risk Ratio (M‐H, Random, 95% CI)	0.71 [0.51, 0.97]

2 Death or neurodevelopmental impairment in early years	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3 Severe intraventricular haemorrhage (IVH grades 3, 4) Show forest plot	4	1689	Risk Ratio (M‐H, Random, 95% CI)	0.84 [0.54, 1.32]

4 Intraventricular haemorrhage (IVH, all grades) Show forest plot	4	1689	Risk Ratio (M‐H, Random, 95% CI)	0.78 [0.52, 1.18]

5 Periventricular leukomalacia (PVL) Show forest plot	2	1448	Risk Ratio (M‐H, Random, 95% CI)	0.52 [0.23, 1.19]

6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation) Show forest plot	4	1587	Risk Ratio (M‐H, Random, 95% CI)	1.05 [0.95, 1.15]

7 Maternal blood loss of 500 mL or greater Show forest plot	1	86	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 9. DCC with immediate neonatal care after cord clamping vs ECC (low risk of bias)

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Comparison 10. DCC with immediate neonatal care with cord intact vs ECC (low risk of bias)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death of baby (up to discharge) Show forest plot	1	270	Risk Ratio (M‐H, Random, 95% CI)	0.47 [0.20, 1.11]

2 Death or neurodevelopmental impairment in early years Show forest plot	1	218	Risk Ratio (M‐H, Random, 95% CI)	0.61 [0.39, 0.96]

3 Severe intraventricular haemorrhage (IVH grades 3, 4) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.84 [0.29, 2.45]

4 Intraventricular haemorrhage (IVH, all grades) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.90 [0.64, 1.26]

5 Periventricular leukomalacia (PVL) Show forest plot	1	266	Risk Ratio (M‐H, Random, 95% CI)	0.86 [0.32, 2.31]

6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation) Show forest plot	1	249	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.66, 1.37]

7 Maternal blood loss of 500 mL or greater Show forest plot	1	254	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.72, 1.22]

Comparison 10. DCC with immediate neonatal care with cord intact vs ECC (low risk of bias)

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Comparison 11. DCC with immediate neonatal care after cord clamping vs UCM (low risk of bias)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death of baby (up to discharge) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	1.74 [0.35, 8.78]

2 Death or neurodevelopmental impairment in early years Show forest plot	1	45	Risk Ratio (M‐H, Random, 95% CI)	3.43 [0.77, 15.20]

3 Severe intraventricular haemorrhage (IVH grades 3, 4) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	2.63 [0.11, 61.88]

4 Intraventricular haemorrhage (IVH, all grades) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	2.03 [0.58, 7.09]

5 Periventricular leukomalacia (PVL) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation) Show forest plot	1	58	Risk Ratio (M‐H, Random, 95% CI)	1.16 [0.28, 4.73]

7 Maternal blood loss of 500 mL or greater	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 11. DCC with immediate neonatal care after cord clamping vs UCM (low risk of bias)

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Comparison 12. UCM vs ECC (low risk of bias)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death of baby (up to discharge) Show forest plot	4	533	Risk Ratio (M‐H, Random, 95% CI)	1.18 [0.53, 2.62]

2 Death or neurodevelopmental impairment in early years	0	0	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3 Severe intraventricular haemorrhage (IVH grades 3, 4) Show forest plot	2	260	Risk Ratio (M‐H, Random, 95% CI)	0.72 [0.23, 2.23]

4 Intraventricular haemorrhage (IVH, all grades) Show forest plot	3	333	Risk Ratio (M‐H, Random, 95% CI)	0.81 [0.50, 1.31]

5 Periventricular leukomalacia (PVL) Show forest plot	1	200	Risk Ratio (M‐H, Random, 95% CI)	3.06 [0.13, 74.23]

6 Chronic lung disease (CLD) ‐ oxygen supplement at 36 weeks (corrected for gestation) Show forest plot	3	330	Risk Ratio (M‐H, Random, 95% CI)	0.85 [0.44, 1.64]

7 Maternal blood loss of 500 mL or greater Show forest plot	1	200	Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 12. UCM vs ECC (low risk of bias)

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Efecto del momento adecuado para el pinzamiento del cordón umbilical y otras estrategias para influir en la transfusión placentaria durante el parto prematuro en los resultados maternos y del lactante

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