Díaz-Castro Javier, Florido Jesus, Kajarabille Naroa, Garrido-Sánchez Maria, Padilla Carmen, de Paco Catalina, Navarrete Luis, Ochoa Julio J
Department of Physiology, andInstitute of Nutrition and Food Technology "José Mataix Verdú", University of Granada, Granada, Spain;
Department of Obstetrics and Gynaecology, School of Medicine, University of Granada, Granada, Spain; and.
Pediatrics. 2014 Aug;134(2):257-64. doi: 10.1542/peds.2013-3798. Epub 2014 Jul 14.
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.
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).
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).
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.
脐带结扎和剪断是所有手术中最常见的操作,但脐带结扎的最佳时机存在争议,不同的时机各有优缺点。本研究首次比较了早期和晚期脐带结扎对氧化应激和炎症信号传导的影响,因为脐带结扎时机可能对胎盘到婴儿的血液转移有重大影响,从而改变母体和胎儿组织的氧合,以及炎症介质在整个胎盘中的转移。
在西班牙格拉纳达Clinico San Cecilio医院妇产科服务部选取64名孕妇,入选标准为孕期正常、自然阴道单胎分娩且无疾病的女性。其中一半受试者分娩时新生儿脐带早期结扎(10秒时),另一半受试者分娩时新生儿脐带晚期结扎(2分钟时)。
晚期结扎组红细胞过氧化氢酶活性显著高于早期结扎组(脐静脉P <.01,动脉P <.001)。晚期结扎组超氧化物歧化酶、总抗氧化状态和可溶性肿瘤坏死因子受体II的值均显著高于早期结扎组(分别为P <.01、P <.001和P <.001)。
结果表明晚期脐带结扎有益,这是由于足月新生儿分娩期间抗氧化能力增强以及炎症介导效应得到缓解所致。