CTC’s Australian Placental Transfusion Study (APTS) provides strong evidence that delaying cord clamping for preterm infants by a minute is a simple, safe manoeuvre that reduces the proportion of preterm infants who need a blood transfusion by 10%. Yet, the mechanism behind this reduction is unclear. Is it caused by transfusion of blood from the placenta to the baby after birth (which does increase the baby’s haemoglobin level in the first week)? Alternatively, delaying clamping may reduce severity of illness in the first weeks after birth. This could lead to fewer blood tests, greater tolerance of anaemia, and better opportunities for babies to make their own red cells.

TITANS (Transfusions in the APTS Newborns Study) aims to obtain and analyse more data about the babies in APTS, to investigate deferred cord clamping as a method to reduce the need for blood transfusion in babies.



NHMRC Clinical Trials Centre, Mater Misericordiae Ltd.

Chief Investigators:

Helen Liley, Anna Lene Seidler, Ava Grace Tan-Koay, William Tarnow-Mordi, Lisa Askie

Trial reg no.:


Contact email:



National Blood Authority (Grant ID 314)


Tan-Koay AG, Libesman S, Kluckow M, Gill AW, de Waal K, Tarnow-Mordi W, Robledo KP, Liley HG*, Seidler AL*. (*shared senior authorship) Protocol for a Nested, Retrospective Study of the Australian Placental Transfusion Study Cohort. Cureus. 2022 Aug 4;14(8). https://doi.org/10.7759/cureus.27693