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A survey of level 3 NICUs in Utah to the June 2025 American Academy of Pediatrics Committee on Fetus and Newborn clinical report on postnatal cord blood sampling

Journal of Perinatology (2025)Cite this article

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The American Academy of Pediatrics (AAP) Committee on Fetus and Newborn (COFN) recently published a clinical report advocating umbilical cord blood as the preferred source for initial laboratory testing of infants admitted to a neonatal intensive care unit (NICU) [1]. The report stated that at the delivery and admission of a preterm or term infant, initial blood testing should be obtained from umbilical cord blood, not by neonatal phlebotomy. Summary points included: (1) the painless procedure was well studied; (2) it provides reliable results of complete blood counts, blood cultures, leukocyte differential counts, blood type and crossmatch, genetic studies, coagulation tests, chemistry, and metabolic testing; (3) it is typically successful even after delayed cord clamping; and (4) it will reduce the initial blood loss of newborns and improved blood culture results because of the larger blood volume inoculum [1].

We were uncertain whether all our level III NICUs were aware of or were already practicing the recommendations made in the COFN report. Such information would help focus our educational outreach activities. Thus, we contacted the medical directors of the ten level III NICUs in Utah. Using a simple email questionnaire, we assessed five metrics relevant to the COFN report: (1) is your NICU aware of the COFN report; (2) does your NICU have a policy for obtaining blood tests using umbilical cord blood; (3) does your NICU attempt to obtain each test mentioned in the report using cord blood; (4) does your NICU prefer drawing cord blood from the umbilical or placental surface vein, or from a cord segment; and (5) do you agree that this practice is beneficial and should be routine. Our email stated that the information would be used for academic purposes, and responses were voluntary and not identifiable by the hospital or medical group. We attached a copy of the COFN report [1] and the five questions outlined above. Because the information collected was about unit practices, not individuals, the activity was outside the DHHS definition of human subject research.

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References

  1. Kaufman DA, Lucke AM, Cummings J, American Academy of Pediatrics, Committee on Fetus and Newborn Postnatal cord blood sampling: clinical report. Pediatrics. 2025;155:e2025071811.

  2. Kaufman DA. Pediatrics On Call (podcast)—American Academy of Pediatrics—Listen Notes. Pediatrics On Call podcast, June 24, 2025; Season 5 Episode 252.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA

    Robin K. Ohls, Timothy M. Bahr & Robert D. Christensen

  2. Neonatology Research and Clinical Program, Intermountain Health, Murray, UT, USA

    Timothy M. Bahr & Robert D. Christensen

  3. Division of Neonatology, Department of Pediatrics, University of Virginia School of Medicine and the American Academy of Pediatrics Committee on Fetus and Newborn, Charlottesville, VA, USA

    David A. Kaufman

Authors
  1. Robin K. Ohls
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  2. Timothy M. Bahr
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  3. David A. Kaufman
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  4. Robert D. Christensen
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Contributions

Conceptualization: RKO, TMB, DAK, RDC. Methodology: RDC, TMB, DAK, RKO. Original draft preparation: RDC. Review and editing: RKO, TMB, DAK, RDC.

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Correspondence to Robin K. Ohls.

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Ohls, R.K., Bahr, T.M., Kaufman, D.A. et al. A survey of level 3 NICUs in Utah to the June 2025 American Academy of Pediatrics Committee on Fetus and Newborn clinical report on postnatal cord blood sampling. J Perinatol (2025). https://doi.org/10.1038/s41372-025-02418-7

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  • DOI: https://doi.org/10.1038/s41372-025-02418-7

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