The influence of delayed cord clamping and cord milking on inflammatory cytokines in umbilical vein and neonatal circulation

IntroductionThe purpose of the present study was to compare the levels of tumor necrosis factor (TNF-), and interleukins (IL) 1, 6, 8 and 10 in the umbilical cord and neonatal circulation among neonates with early and late cord clamping. Material and methodsA 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 24h from the median cubital or basilic vein of the neonate. ResultsSignificant differences were noted in the hematocrit and hemoglobin levels at 24h 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- and TNF- neonatal values at 24h (r=0.551, p=0.022) in the early clamped group. Significant correlations were also noted between umbilical cord TNF- and TNF- neonatal values at 24h (r=0.728, p=0.001), umbilical cord IL-10 and neonatal IL-10 at 24h (r=0.487, p=0.047) and umbilical cord IL-1b and neonatal IL-1b at 24h (r=0.516, p=0.034). ConclusionsDelayed 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.