RETRACTED ARTICLE: Early or delayed cord clamping during transition of term newborns: does it make any difference in cerebral tissue oxygenation?

According to the World Health Organization’s recommendation,delayed cord clamping in term newborns can have various benefits. Cochranemetaanalyses reported no differences for mortality and early neonatal morbidityalthough a limited number of studies investigated long-term neurodevelopmentaloutcomes. The aim of our study is to compare the postnatal cerebral tissueoxygenation values in babies with early versus delayed cord clamping born afterelective cesarean section.

In this study, a total of 80 term newborns delivered by electivecesarean section were included. Infants were randomly grouped as early (clampedwithin 15 s, n:40) and delayed cord clamping (at the 60th second, n:40)groups. Peripheral arterial oxygen saturation (SpO2) and heart rate weremeasured by pulse oximetry while regional oxygen saturation of the brain (rSO2)was measured with near-infrared spectrometer. Fractional tissue oxygenextraction (FTOE) was calculated for every minute between the 3rd and 15thminute after birth. (FTOE = pulse oximetry value-rSO2/pulseoximetry value). The measurements were compared for both groups.

The demographical characteristics, SpO2 levels (except postnatal6th, 8th, and 14th minutes favoring DCC p < 0.05), heart rates and umbilical cord bloodgas values were not significantly different between the groups (p > 0.05). rSO2 values weresignificantly higher while FTOE values were significantly lower for every minutebetween the 3rd and 15th minutes after birth in the delayed cord clamping group(p < 0.05).

Our study revealed a significant increase in cerebral rsO2 valuesand a decrease in FTOE values in the delayed cord clamping (DCC) group,indicating a positive impact on cerebral oxygenation and hemodynamics.Furthermore, the DCC group exhibited a higher proportion of infants withcerebral rSO2 levels above the 90th percentile. This higher proportion, alongwith a lower of those with such parameter below the 10th percentile, suggestthat DCC may lead to the targeted/optimal cerebral oxygenetaion of these babies.As a result, we recommend measuring cerebral oxygenation, in addition toperipheral SpO2, for infants experiencing perinatal hypoxia and receivingsupplemental oxygen.