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Am J Perinatol 2024; 41(05): 575-579
DOI: 10.1055/a-1739-3529
Original Article

Comparison of Three Different Cord Clamping Techniques Regarding Oxidative–Antioxidative Capacity in Term Newborns

İshak Kartal
1   Department of Pediatrics, Viransehir State Hospital, Sanliurfa, Turkey
,
Aslihan Abbasoglu
2   Department of Pediatrics, Neonatology, İzmir Katip Celebi University, Faculty of Medicine, Balatcik Mahallesi, Çiğli İzmir, Turkey
,
Seyithan Taysi
3   Department of Medical Biochemistry, Gaziantep University, Faculty of Medicine, Gaziantep, Gaziantep, Turkey
› Institutsangaben Funding This study was funded by the Science Research Project Coordination Unit of Gaziantep University (grant no.: 05/02/2021/TF.UT.19.44).
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Abstract

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.

Key Point

  • 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.

Keywords

umbilical cord - milking - oxidant - antioxidant - peroxynitritis

Ethical Approval

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.




Publikationsverlauf

Eingereicht: 19. Oktober 2021

Angenommen: 12. Januar 2022

Accepted Manuscript online:
13. Januar 2022

Artikel online veröffentlicht:
10. Februar 2022

© 2022. Thieme. All rights reserved.

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  • References

  • 1 Oh W. Timing of umbilical cord clamping at birth in full-term infants. JAMA 2007; 297 (11) 1257-1258
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 5 Committee opinion no. 684 summary: delayed umbilical cord clamping after birth. Obstet Gynecol 2017; 129 (01) 1
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 12 Katheria AC. Umbilical cord milking: a review. Front Pediatr 2018; 6: 335
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 18 Robles R, Palomino N, Robles A. Oxidative stress in the neonate. Early Hum Dev 2001; 65 (suppl): S75-S81
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 22 Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem 2005; 38 (12) 1103-1111
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 24 Ibrahim HM, Krouskop RW, Lewis DF, Dhanireddy R. Placental transfusion: umbilical cord clamping and preterm infants. J Perinatol 2000; 20 (06) 351-354
    CrossrefPubMedGoogle Scholar