Trial reportBMC pregnancy and childbirth2025
Impact of early versus delayed cord clamping on oxidative stress in neonates with intrauterine growth restriction: a prospective randomized controlled trial.
Trial report in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07031583 (Impact of Early Versus Delayed Cord Clamping on Oxidative Stress in Neonates With Intrauterine Growth Restriction), which is not on this map. Not yet cited in PubMed.
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Impact of Early Versus Delayed Cord Clamping on Oxidative Stress in Neonates With Intrauterine Growth Restriction: A Prospective Comparative Study
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4 authors.
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Abstract
backgroundOxidative stress is a key contributor to the pathophysiology of intrauterine growth restriction (IUGR). Evidence regarding the influence of umbilical cord clamping timing on neonatal oxidative balance remains limited. This study evaluated the effect of delayed cord clamping (DCC) on oxidative stress biomarkers in IUGR and appropriate-for-gestational-age (AGA) neonates.
methodsThis single-center, prospective randomized controlled trial included 90 neonates born at ≥ 29 weeks of gestation. Participants were randomized into four subgroups: IUGR-DCC (n = 25), IUGR-ECC (early cord clamping)(n = 32), AGA-DCC (n = 17), and AGA-ECC (n = 16). DCC was defined as clamping at 120 ± 30 s and ECC within 60 s after birth. Umbilical cord blood was analyzed for total antioxidant status (TAS), total oxidant status (TOS), catalase activity, and oxidative stress index (OSI).
resultsIn IUGR infants, DCC was associated with higher TAS (2.01 ± 0.20 vs. 1.69 ± 0.22 mmol/L, p < 0.001) and catalase activity (74.5 ± 13.7 vs. 63.8 ± 11.1 kU/L, p = 0.004), and lower TOS (31.8 ± 6.2 vs. 42.7 ± 7.5 µmol/L, p < 0.001) and OSI (15.8 ± 3.2 vs. 25.4 ± 4.8, p < 0.001) compared with ECC. Similar differences were found among AGA infants: TAS (2.12 ± 0.18 vs. 1.87 ± 0.20, p < 0.001), catalase (78.1 ± 10.6 vs. 69.3 ± 12.6, p = 0.006), TOS (26.2 ± 5.2 vs. 36.1 ± 6.7, p < 0.001), and OSI (12.5 ± 2.7 vs. 19.1 ± 3.6, p < 0.001). Multivariate analysis confirmed DCC as an independent predictor of improved oxidative markers.
conclusionsDelayed cord clamping improved oxidative stress profiles in both IUGR and AGA neonates, with greater benefit in growth-restricted infants. These results provide biochemical support for DCC, though larger multicenter trials are required to determine long-term clinical relevance.
trial registrationThis study was prospectively registered at ClinicalTrials.gov under registration number NCT07031583 on 13 June 2025.
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