Evaluation of total antioxidant capacity, total oxidantcapacity and peroxinitride levels in immediatelyumbilical cord, late clamed umblycal cord and cuttedumblycal cord in term newborns

Aim and Background: Fetomaternal compounds are exposed to oxidant stress and inflammation during birth. Cord clamping timing may have a significant influence on oxidant and antioxidant status. In this study, we aimed to show the relationship between early (immediate) cord clamping, delayed cord clamping and cut cord milking techniques applied in umbilical cord management with total oxidant capacity (TOC), total antioxidant capacity (TAC) and peroxynitrite level. Methods: Sixty-nine term infants were selected at Gaziantep University Hospital with APGAR score of 7 and above in the first and fifth minutes. The mothers of all infants had uncomplicated pregnancy, had no congenital anomaly, and delivered by cesarean section. A total of 69 newborns were randomised to one of three groups: early cord clamping (n: 23), delayed cord clamping (n: 23) or cut umblical cord milking (n: 23). The maternal age, gestational age, birth weight, time of birth, sex, and APGAR scores were recorded from files. After all newborn babies were taken under radiant heater, blood samples were collected from the umbilical cord. The plasma samples were then frozen and stored at -80 °C until analysis and TOC, TAC and peroxynitrite levels were studied. Results: The ages of the mothers participating in the study were between 17 and 42, with an average of 29.14 ± 6.28. 30 (43.5%) of the babies were girls and 39 (56.5%) were boys. No differences were found in terms of maternal age, gestational age, first minute APGAR score, birth weight, sex and time of birth. The 5th minute APGAR score of the babies in early cord clamping group was significantly lower than the babies in delayed cord clamping and cut cord milking group (p = 0.034; p = 0.034; p <0.05). The TOC, oxidative stress index (OSI) and Peroxynitrite measurements of three groups did not differ statistically (p> 0.05). Early cord clamping caused the highest TOC mean value, indicating that oxidation reactions are increased in the early cord clamping group compared with other groups. However, when the group averages were compared among themselves, there was no significant difference. The TAC value of the cut umbilical cord milking group was significantly higher than the patients with early cord clamping and the delayed cord clamping group (p = 0.002; p = 0.019; p <0.05). Conclusion: The total antioxidant capacity is greater with cut umblical cord milking than with early or delayed cord milking. We suggest that cut umbilical cord milking will be a feasible method in maternal-fetal medicine due to the absence of time loss in neonatal intervention at birth, its contribution to placental transfusion and the convenience of extrauterine adaptation to life. Keywords: Umblical Cord, Oxidant, Antioxidant, Peroxynitritis.