Background: Prompt clamping of the umbilical cord at birth is a widespread practice, though this might interfere with the normal process of foetal to neonatal transition and decrease the infant s stores of red blood cells and body iron. Objective: To determine any potential benefit or harm to mother or neonate from early clamping of the umbilical cord in vaginally born term infants. Search methods: Systematic searches in the Cochrane library, MEDLINE and EMBASE, and hand search of secondary references in included studies and previous reviews. Selection criteria: Randomized controlled trials comparing early (≤15 sec) with delayed (≥2 min or end of pulsations) umbilical cord clamping at birth in infants born vaginally at term. Data extraction: Two reviewers independently assessed eligibility and quality of trials. The author extracted data for predefined maternal and neonatal outcomes of interest. Main results: No effect on maternal outcomes was documented. Early cord clamping causes a considerable reduction in new-born haemoglobin (MD -1.83g/dL [-2.58, -1.09]) and haematocrit (Hedges s g -0.69 [-0.94, -0.45]) at birth. This is accompanied by a decrease in the risk of polycythaemia, defined as haematocrit >65%, (RR 0.40 [0.22-0.71]). Harms related to the intervention are increased risk of anaemia (RR=1.38 [1.10-1.74]) and iron deficiency (RR=3.54 [1.89-6.63]) in the first three to six months of life. Conclusions: Early clamping of the umbilical cord has no documented benefits in vaginally born, healthy, term infants. However, its haematocrit reducing effect should be explored in infants at high risk of hyperviscosity syndrome. There is substantial evidence that early cord clamping can inflict suboptimal iron status and increased risk of anaemia in the neonatal period up to six months of age. At present, there is lack of evidence for long term effects on growth or neurodevelopment. Early cord clamping at birth appears to be a potentially harmful practice and ought to be discouraged in normal term pregnancies.