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Transplacental oxygen transfer during physiological-based cord clamping in preterm lambs
Ebony R Cannata1,2, Janneke Dekker3, Stuart B Hooper1,2
1The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.
Journal of Applied Physiology (Bethesda, Md. : 1985)
|October 24, 2025
Summary
Physiological-based cord clamping (PBCC) with ventilation in lambs reduced placental oxygen uptake. High oxygen levels during PBCC reversed oxygen transfer, with the mother acting as an oxygen sink to protect newborns.
Area of Science:
- Perinatal Physiology
- Neonatal Resuscitation
- Fetal Development
Background:
- Physiological-based cord clamping (PBCC) involves initial lung aeration before umbilical cord clamping.
- The impact of neonatal pulmonary gas exchange on transplacental oxygen transfer during PBCC is not well understood.
Purpose of the Study:
- To investigate the effects of supplemental oxygen ventilation during PBCC on transplacental oxygen transfer in preterm lambs.
Main Methods:
- Instrumented preterm lambs (n=8) underwent mechanical ventilation with increasing fraction of inspired oxygen (FiO2: 0.21, 0.5, 1.0) before cord clamping.
- Transplacental oxygen transfer was measured using catheters and flow probes.
- Data analyzed with mixed-effects analysis and post hoc tests.
Main Results:
- Ventilation during PBCC significantly decreased placental oxygen uptake as FiO2 increased.
- Ventilation with FiO2 of 1.0 reversed oxygen transfer, from lamb to ewe.
- Umbilical oxygen delivery to the lamb remained unchanged.
Conclusions:
- Neonatal pulmonary oxygen uptake during PBCC reduces placental oxygen uptake.
- The mother can serve as an "oxygen sink" during PBCC with high FiO2, mitigating hyperoxemia risk in newborns.
