The Timing of Cord Clamping and Oxidative Stress in Term Newborns

The Timing of Cord Clamping and Oxidative Stress in Term Newborns

1. Javier Díaz-Castro, PhD^a,^b, 
2. Jesus Florido, MD^c, 
3. Naroa Kajarabille, BD^a,^b,
4. Maria Garrido-Sánchez, MD^c,^d, 
5. Carmen Padilla, MD^c,^d, 
6. Catalina de Paco, MD^c,^d, 
7. Luis Navarrete, MD^c, and 
8. Julio J. Ochoa, PhD^a,^b

+Author Affiliations

1. ^aDepartment of Physiology, and
2. ^bInstitute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, Granada, Spain;
3. ^cDepartment of Obstetrics and Gynaecology, School of Medicine, University of Granada, Granada, Spain; and
4. ^dService of Obstetrics and Gynaecology, University Hospital San Cecilio, Granada, Spain

ABSTRACT

BACKGROUND: Clamping and cutting of the umbilical cord is the most prevalent of all operations, but the optimal timing of cord clamping is controversial, with different timings offering advantages and disadvantages. This study, for the first time, compares the influence of early and late cord clamping in correlation with oxidative stress and inflammation signaling, Because cord clamping timing may have a significant influence on placenta-to-infant blood transfer, thereby modifying oxygenation of maternal and fetal tissues, and on the transfer of inflammatory mediators throughout the placenta.

METHODS: Sixty-four pregnant subjects were selected at the Gynecology and Obstetrics Services Department of the Clinico San Cecilio Hospital, Granada, Spain, based on disease-free women who experienced a normal course of pregnancy and a spontaneous, vaginal, single delivery. Half of the subjects had deliveries with early-clamped newborn infants (at 10 s), and the other half had late-clamped deliveries (at 2 min).

RESULTS: Erythrocyte catalase activity was significantly greater in the late-clamped group than in the early-clamped group (P < .01 for the umbilical vein and P < .001 for the artery). The values for superoxide dismutase, total antioxidant status, and soluble tumor necrosis factor receptor II were all significantly higher in the late-clamped group compared with the early-clamped group (P < .01, P < .001, and P < .001, respectively).

CONCLUSIONS: The results suggest a beneficial effect of late cord clamping, produced by an increase in antioxidant capacity and moderation of the inflammatory-mediated effects induced during delivery of term neonates.

Key Words:

• cord clamping timing (early or late)
 
• term neonate
 
• antioxidant defense
• oxidative damage
 
• inflammation

• Accepted May 21, 2014.

• Copyright © 2014 by the American Academy of Pediatrics

Responses to this article

• Re:Unproven increase in neonatal antioxidant capacities caused by delayed cord-clamping.

  • Julio J. Ochoa

  Pediatrics published online September 2, 2014
  • Full Text
• Unproven increase in neonatal antioxidant capacities caused by delayed cord-clamping.

  • Jose Luis Diaz-Rossello and
   
  • Marianela Rodriguez Rey

  Pediatrics published online August 29, 2014
  • Full Text