1st Department of Obstetrics and Gynecology, Alexandra University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Acta Obstet Gynecol Scand. 2018 May;97(5):624-628. doi: 10.1111/aogs.13294. Epub 2018 Feb 8.
The purpose of the present study was to compare the levels of tumor necrosis factor α (TNF-α), and interleukins (IL) 1, 6, 8 and 10 in the umbilical cord and neonatal circulation among neonates with early and late cord clamping.
A consecutive series of 76 cases of uncomplicated pregnancy and an uneventful parturition was evaluated. In 40 cases, delayed cord clamping was used and in the remaining 36, early cord clamping was practiced. Blood samples were collected from the umbilical vein immediately after cord clamping and at 24 h from the median cubital or basilic vein of the neonate.
Significant differences were noted in the hematocrit and hemoglobin levels at 24 h that favored delayed clamping. None of the evaluated markers of inflammation differ between the two groups. Spearman's rho revealed a significant correlation between umbilical cord TNF-α and TNF-α neonatal values at 24 h (r = 0.551, p = 0.022) in the early clamped group. Significant correlations were also noted between umbilical cord TNF-α and TNF-α neonatal values at 24 h (r = 0.728, p = 0.001), umbilical cord IL-10 and neonatal IL-10 at 24 h (r = 0.487, p = 0.047) and umbilical cord IL-1b and neonatal IL-1b at 24 h (r = 0.516, p = 0.034).
Delayed cord clamping or cord milking does not alter the levels of inflammatory cytokines in cord blood and neonatal serum. Future studies should evaluate the impact of delayed cord clamping in selected high-risk pregnancies.
本研究的目的是比较早期和晚期夹脐带对新生儿脐带和新生儿循环中肿瘤坏死因子-α（TNF-α）以及白细胞介素（IL）1、6、8 和 10 水平的影响。
评估了连续 76 例无并发症妊娠和无并发症分娩的病例。在 40 例中使用了延迟夹脐带，在其余 36 例中则采用了早期夹脐带。在夹脐带后立即从脐静脉和新生儿肘正中或贵要静脉采集血样。
24 小时时的血细胞比容和血红蛋白水平存在显著差异，这有利于延迟夹脐带。两组之间的炎症标志物均无差异。Spearman 相关系数显示，在早期夹脐带组中，脐带 TNF-α和新生儿 24 小时 TNF-α值之间存在显著相关性（r=0.551，p=0.022）。脐带 TNF-α和新生儿 24 小时 TNF-α值（r=0.728，p=0.001）、脐带 IL-10 和新生儿 24 小时 IL-10 值（r=0.487，p=0.047）以及脐带 IL-1b 和新生儿 24 小时 IL-1b 值（r=0.516，p=0.034）之间也存在显著相关性。
延迟夹脐带或脐带挤奶不会改变脐带血和新生儿血清中炎症细胞因子的水平。未来的研究应评估在选定的高危妊娠中延迟夹脐带的影响。
