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| Name | Class |
|---|---|
| Kayseri City Hospital | OTHER_GOV |
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This study investigated whether delaying the clamping of the umbilical cord after birth can reduce harmful oxidative stress in newborns, especially in those who did not grow well during pregnancy (intrauterine growth restriction - IUGR). By comparing early and delayed cord clamping in 90 newborns, researchers found that delayed clamping improved antioxidant protection and reduced signs of oxidative damage. These benefits were more significant in babies with IUGR. The results suggest that delaying cord clamping could help support better early health outcomes in vulnerable newborns.
This prospective, randomized clinical study examined the effects of early versus delayed umbilical cord clamping on oxidative stress in newborns, with a specific focus on those diagnosed with intrauterine growth restriction (IUGR). Oxidative stress occurs when the body has an imbalance between harmful molecules (oxidants) and protective defenses (antioxidants), which may negatively affect newborns, especially those who experienced limited growth in the womb.
A total of 90 newborns were included and grouped based on their growth status (IUGR or appropriate for gestational age) and the timing of cord clamping (early: within 60 seconds; delayed: after 60-180 seconds). Blood samples were taken from the umbilical cord immediately after birth to measure markers of oxidative stress and antioxidant activity.
The study found that delayed cord clamping was associated with improved antioxidant levels and reduced oxidative stress, particularly in growth-restricted infants. These findings suggest that delaying cord clamping may provide protective health benefits for high-risk newborns.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| IUGR-Delayed Cord Clamping (IUGR-DCC) | Experimental | Neonates diagnosed with intrauterine growth restriction (IUGR) received delayed umbilical cord clamping, performed 60-180 seconds after birth. Umbilical cord blood samples were collected immediately for oxidative stress analysis. |
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| IUGR - Early Cord Clamping (IUGR-ECC) | Active Comparator | Neonates with IUGR underwent early umbilical cord clamping, within 60 seconds after birth. Umbilical cord blood samples were collected for comparison with delayed clamping groups. |
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| AGA - Delayed Cord Clamping (AGA-DCC) | Experimental | Neonates appropriate for gestational age (AGA) underwent delayed cord clamping, performed 60-180 seconds after birth. Biochemical markers of oxidative stress were measured using cord blood samples. |
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| AGA - Early Cord Clamping (AGA-ECC) | Active Comparator | AGA neonates received early umbilical cord clamping, within the first 60 seconds post-delivery. Cord blood was analyzed for oxidative stress markers as a baseline comparator. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Delayed Umbilical Cord Clamping (DCC) | Procedure | The umbilical cord was clamped between 60 and 180 seconds after birth or after the cessation of cord pulsation, in accordance with WHO recommendations. This procedure allows for additional placental transfusion and potential enhancement of neonatal antioxidant capacity. |
| Measure | Description | Time Frame |
|---|---|---|
| Total Antioxidant Status (TAS) | TAS levels in umbilical cord blood will be measured using a validated colorimetric method (Erel, 2004). Higher values indicate greater antioxidant capacity. | At birth (within 30 minutes postpartum) |
| Total Oxidant Status (TOS) | TOS levels in umbilical cord blood will be assessed using a spectrophotometric assay (Erel, 2005). Elevated levels reflect greater oxidative stress. | At birth (within 30 minutes postpartum) |
| Oxidative Stress Index (OSI) | OSI will be calculated as the ratio of TOS to TAS multiplied by 10. It provides a combined indicator of oxidative balance. | At birth (within 30 minutes postpartum) |
| Measure | Description | Time Frame |
|---|---|---|
| Catalase Enzyme Activity | Catalase activity in umbilical cord blood will be measured via spectrophotometry. Catalase is an endogenous antioxidant enzyme that reflects neonatal oxidative defense capacity. | At birth (within 30 minutes postpartum) |
| 1-Minute and 5-Minute APGAR Scores |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kayseri City Hospital | Kayseri | Kayseri | 38130 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25940692 | Result | Abdel Ghany EA, Alsharany W, Ali AA, Youness ER, Hussein JS. Anti-oxidant profiles and markers of oxidative stress in preterm neonates. Paediatr Int Child Health. 2016 May;36(2):134-40. doi: 10.1179/2046905515Y.0000000017. | |
| 41350641 | Derived | Demir MB, Copuroglu M, Ozdemir A, Kocer D. Impact of early versus delayed cord clamping on oxidative stress in neonates with intrauterine growth restriction: a prospective randomized controlled trial. BMC Pregnancy Childbirth. 2025 Dec 5;25(1):1291. doi: 10.1186/s12884-025-08335-z. |
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| ID | Term |
|---|---|
| D005317 | Fetal Growth Retardation |
| ID | Term |
|---|---|
| D005315 | Fetal Diseases |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
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| ID | Term |
|---|---|
| D000087526 | Umbilical Cord Clamping |
| ID | Term |
|---|---|
| D036861 | Delivery, Obstetric |
| D013513 | Obstetric Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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Four-group parallel design based on neonatal growth status and cord clamping timing.
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The laboratory personnel responsible for analyzing the biochemical markers (TAS, TOS, and catalase) were blinded to the group assignments of the neonates. Samples were coded and processed anonymously to ensure objective assessment of oxidative stress parameters. Other study personnel, including those involved in clinical procedures, were not blinded.
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| Early Umbilical Cord Clamping (ECC) | Procedure | The umbilical cord was clamped within the first 60 seconds after birth. This represents the standard or traditional approach used for comparison with delayed clamping in terms of oxidative stress outcomes. |
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Clinical scoring system evaluating neonatal adaptation at 1 and 5 minutes of life (heart rate, respiration, muscle tone, reflex, color). Higher scores indicate better clinical condition. |
| Within 5 minutes after birth |
| Birth Weight | Neonatal birth weight (in grams) will be recorded and compared across groups to evaluate any association with clamping time and oxidative status. | At birth |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D006130 | Growth Disorders |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |