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Comparison of Three Different Cord Clamping Techniques Regarding Oxidative–Antioxidative Capacity in Term NewbornsFunding This study was funded by the Science Research Project Coordination Unit of Gaziantep University (grant no.: 05/02/2021/TF.UT.19.44).
Objective As newborns are exposed to oxidative stress during delivery, cord clamping techniques play significant role on antioxidant status. In this study, we aimed to show the relationship between early cord clamping (ECC), delayed cord clamping (DCC), and cut–umbilical cord milking (C-UCM) techniques with total oxidant capacity (TOC), total antioxidant capacity (TAC), and peroxynitrite levels.
Study Design Sixty-nine term infants were selected with Apgar's score of 7 and above in the 1 minute and 5 minutes. The mothers of all infants had uncomplicated pregnancy, had no congenital anomaly, and delivered by cesarean section. Newborns were randomized to one of three groups: ECC (n: 23), DCC (n: 23), or C-UCM (n: 23). After all newborn babies were taken under radiant heater, blood samples were collected from the UC. The plasma samples were then frozen and stored at −80°C until analysis and TOC, TAC, and peroxynitrite levels were studied.
Results The ages of the mothers participating in the study were between 17 and 42 years, with an average of 29.14 ± 6.28. Thirty (43.5%) of the babies were girls and 39 (56.5%) were boys. The 5-minute Apgar's score of the babies in ECC group was significantly lower than the babies in DCC and cut cord milking group (p = 0.034; p = 0.034; p < 0.05). The TOC, oxidative stress index (OSI), and peroxynitrite measurements of three groups did not differ statistically. The TAC value of the C-UCM group was significantly higher than the patients with the ECC and DCC groups (p = 0.002; p = 0.019; p < 0.05).
Conclusion C-UCM and DCC would be feasible methods by increasing antioxidant status and providing protective effect on the future health of the term newborns.
Cord clamping techniques play significant role on antioxidant status of the newborn babies.
C-UCM and DCC are feasible methods for term newborns.
Cord clamping methods may play a protective effect on the future health of term newborns.
The trial protocol has been approved by the Ethics Committee of Gaziantep University (identifier no.: 2019/254). Written informed consent was obtained from the volunteer pregnant women before the delivery.
Received: 19 October 2021
Accepted: 12 January 2022
13 January 2022 (online)
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- 1 Oh W. Timing of umbilical cord clamping at birth in full-term infants. JAMA 2007; 297 (11) 1257-1258
- 2 Committee on Obstetric Practice, American College of Obstetricians and Gynecologists. Committee opinion no.543: timing of umbilical cord clamping after birth. Obstet Gynecol 2012; 120 (06) 1522-1526
- 3 Wyllie J, Perlman JM, Kattwinkel J. et al; Neonatal Resuscitation Chapter Collaborators. Part 7: neonatal resuscitation: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 2015; 95: e169-e201
- 4 Wyckoff MH, Aziz K, Escobedo MB. et al. Part 13: neonatal resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015; 132 (18, Suppl 2): S543-S560
- 5 Committee opinion no. 684 summary: delayed umbilical cord clamping after birth. Obstet Gynecol 2017; 129 (01) 1
- 6 Al-Wassia H, Shah PS. Efficacy and safety of umbilical cord milking at birth: a systematic review and meta-analysis. JAMA Pediatr 2015; 169 (01) 18-25
- 7 Katheria AC, Truong G, Cousins L, Oshiro B, Finer NN. Umbilical cord milking versus delayed cord clamping in preterm infants. Pediatrics 2015; 136 (01) 61-69
- 8 Erickson-Owens DA, Mercer JS, Oh W. Umbilical cord milking in term infants delivered by cesarean section: a randomized controlled trial. J Perinatol 2012; 32 (08) 580-584
- 9 Upadhyay A, Gothwal S, Parihar R. et al. Effect of umbilical cord milking in term and near term infants: randomized control trial. Am J Obstet Gynecol 2013; 208 (02) 120.e1-120.e6
- 10 Safarulla A. A review of benefits of cord milking over delayed cord clamping in the preterm infant and future directions of research. J Matern Fetal Neonatal Med 2017; 30 (24) 2966-2973
- 11 Basile S, Pinelli S, Micelli E, Caretto M, Benedetti Panici P. Milking of the umbilical cord in term and late preterm infants. BioMed Res Int 2019; 2019: 9185059
- 12 Katheria AC. Umbilical cord milking: a review. Front Pediatr 2018; 6: 335
- 13 Katheria A, Hosono S, El-Naggar W. A new wrinkle: Umbilical cord management (how, when, who). Semin Fetal Neonatal Med 2018; 23 (05) 321-326
- 14 Argüelles S, Machado MJ, Ayala A, Machado A, Hervías B. Correlation between circulating biomarkers of oxidative stress of maternal and umbilical cord blood at birth. Free Radic Res 2006; 40 (06) 565-570
- 15 Wilinska M, Borszewska-Kornacka MK, Niemiec T, Jakiel G. Oxidative stress and total antioxidant status in term newborns and their mothers. Ann Agric Environ Med 2015; 22 (04) 736-740
- 16 Rajdl D, Racek J, Steinerová A. et al. Markers of oxidative stress in diabetic mothers and their infants during delivery. Physiol Res 2005; 54 (04) 429-436
- 17 Neefjes VM, Evelo CT, Baars LG, Blanco CE. Erythrocyte glutathione S transferase as a marker of oxidative stress at birth. Arch Dis Child Fetal Neonatal Ed 1999; 81 (02) F130-F133
- 18 Robles R, Palomino N, Robles A. Oxidative stress in the neonate. Early Hum Dev 2001; 65 (suppl): S75-S81
- 19 Díaz-Castro J, Florido J, Kajarabille N. et al. The timing of cord clamping and oxidative stress in term newborns. Pediatrics 2014; 134 (02) 257-264
- 20 Moustafa AN, Ibrahim MH, Mousa SO, Hassan EE, Mohamed HF, Moness HM. Association between oxidative stress and cord serum lipids in relation to delayed cord clamping in term neonates. Lipids Health Dis 2017; 16 (01) 210
- 21 Vatansever B, Demirel G, Ciler Eren E. et al. Is early cord clamping, delayed cord clamping or cord milking best?. J Matern Fetal Neonatal Med 2018; 31 (07) 877-880
- 22 Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem 2005; 38 (12) 1103-1111
- 23 Hracsko Z, Hermesz E, Ferencz A. et al. Endothelial nitric oxide synthase is up-regulated in the umbilical cord in pregnancies complicated with intrauterine growth retardation. In Vivo 2009; 23 (05) 727-732
- 24 Ibrahim HM, Krouskop RW, Lewis DF, Dhanireddy R. Placental transfusion: umbilical cord clamping and preterm infants. J Perinatol 2000; 20 (06) 351-354