Is early cord clamping, delayed cord clamping or cord milking best?
OBJECTIVE
To compare the antioxidant status of three cord clamping procedures (early clamping, delayed clamping and milking) by analyzing the thiol-disulfide balance.


METHODS
This randomized controlled study enrolled 189 term infants who were divided into three groups according to the cord clamping procedure: early clamping, delayed clamping and milking. Blood samples were collected from the umbilical arteries immediately after clamping, and the thiol/disulfide homeostasis was analyzed.


RESULTS
The native and total thiol levels were significantly (p < .05) lower in the early cord clamping group compared with the other two groups. The disulfide/total thiol ratio was significantly (p = .026) lower in the delayed cord clamping and milking groups compared with the early clamping groups. Early cord clamping causes the production of more disulfide bonds and lower thiol levels, indicating that oxidation reactions are increased in the early cord clamping procedure compared with the delayed cord clamping and milking procedures.


CONCLUSIONS
The oxidant capacity is greater with early cord clamping than with delayed clamping or cord milking. Delayed cord clamping or milking are beneficial in neonatal care, and we suggest that they be performed routinely in all deliveries.
a Department of Pediatrics , Istanbul Medipol University , Istanbul , Turkey.
Binay
B
Vatansever
b Division of Neonatology , Istanbul Medipol University , Istanbul , Turkey.
Gamze
G
Demirel
c Department of Obstetrics and Gynecology , Istanbul Medipol University , Istanbul , Turkey.
Elif
E
Ciler Eren
d Department of Biochemistry , Yildirim Beyazit University Medical Faculty , Ankara , Turkey.
Ozcan
O
Erel
d Department of Biochemistry , Yildirim Beyazit University Medical Faculty , Ankara , Turkey.
Salim
S
Neselioglu
a Department of Pediatrics , Istanbul Medipol University , Istanbul , Turkey.
Hande Nur
HN
Karavar
a Department of Pediatrics , Istanbul Medipol University , Istanbul , Turkey.
Semra
S
Gundogdu
e Department of Biochemistry , Istanbul Medipol University , Istanbul , Turkey.
Gozde
G
Ulfer
c Department of Obstetrics and Gynecology , Istanbul Medipol University , Istanbul , Turkey.
Selcen
S
Bahadir
b Division of Neonatology , Istanbul Medipol University , Istanbul , Turkey.
Ayhan
A
Tastekin
D000328:Adult; D000704:Analysis of Variance; D004220:Disulfides / Q000097:blood*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006706:Homeostasis; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D018384:Oxidative Stress; D011247:Pregnancy; D013997:Time Factors; D014470:Umbilical Cord
D004220:Disulfides
Cord clamping; antioxidant status; disulphide; milking; oxidant status; thiol