WHAT'S KNOWN ON THIS SUBJECT: Clamping and cutting of the umbilical cord at birth is the most prevalent of all operations; however, the optimal timing of cord clamping is still a controversial issue, with different timings offering advantages and disadvantages.WHAT THIS STUDY ADDS: Our findings suggest a protective effect of late cord clamping, increasing the antioxidant capacity and decreasing the inflammatory-mediated effects induced during delivery of term neonates. 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. Clamping and cutting of the umbilical cord at birth is by far the oldest and most prevalent operation in humans. Although the World Health Organization stated that late cord clamping or not clamping at all represents a more physiologic method of neonatal care, 1 the optimal timing of cord clamping has been a controversial issue for decades, and there is still debate on the issue. 2 The current obstetric approach in Western medicine is to clamp the cord within the first 10 to 15 seconds after birth. 3 However, there has been no sound evidence in favor of this approach in comparison with the ageold practice of clamping the cord between 1 and 3 minutes after birth. 4 Earlier physiologic studies have shown that, of the total blood volume in combined fetal-placental circulation at full gestation, ∼25% to 60% (54-160 mL) is found in placental circulation, and as many as 60% of the fetal red blood cells are f...