Evaluation of the effect of late umbilical clamping on renal functions and perfusion in term babies born with normal spontaneous vaginal delivery by near infrared spectroscopy, cystatin C and creatinine

AIM: Delayed clamping of the umbilical cord results in gradual increase in placental blood transfusion volume, thereby allowing the newborn to receive greater blood volume. In this study, it was aimed to determine the effect of delayed clamping of the umbilical cord on the functions and perfusion of the kidneys. METHOD: The study included 93 healthy term newborn babies born with normal spontaneous vaginal delivery between 38-41 weeks of gestation. According to the cord clamping time, infants were divided into 2 groups, in which delayed umbilical cord clamping (DCC) was performed for at least 60 seconds and early umbilical cord clamping (ECC) was performed for less than 15 seconds. There were 46 newborn babies in the DCC group and 47 newborns in the ECC group. Hemogram and blood gas from cord blood of newborns; hemogram, cystatin C, creatinine and other biochemical parameters from venous blood at the postnatal 24th hour and on the 3rd day; renal NIRS measurements, demographic data, blood pressure and urine output continuously in the first 3 hours after birth, on the 12th and 24th hour were examined. RESULTS: When the serum cystatin C levels of the newborn babies both at the 24th hour and on the 3rd day were compared, it was found to be significantly low in the DCC group. When serum creatinine levels of the babies at the 24th hour and on the 3rd day, it was found to be low in the DCC group, but no statistically significance was detected. When the NIRS measurements of the two groups were compared, the mean measurement values of the left kidney in the DCC group at 2-5, 30-60, 90-120, 120-150, 150-180 minutes, in the first 3 hours and instantaneous measurements at the 12th hour were found statistically significantly higher. The mean measurements of the right kidney at 2-5, 5-10, 10-15, 15-30, 30-60, 60-90, 90-120 minutes, 120-150 minutes, in the first 3 hours and instantaneous measurements at the 12th and 24th hour were found to be significantly higher in the DCC group. CONCLUSION: In addition to the known benefits of delayed clamping of the umbilical cord, it was observed that it has positive effects on kidney functions and perfusion. Key Words: delayed umbilical cord clamping, cystatin C, creatinine, NIRS